Chronic Fatigue Syndrome

Aetna covers as medically necessary exclusionary tests for evaluating suspected chronic fatigue syndrome: ANA, basic blood/serum chemistries (BUN, calcium, creatinine, glucose, electrolytes) and CBC with differential, with the specific tests selected based on case characteristics. Aetna considers ACTH stimulation testing, blood and CSF cytokine assays, ELISA/ACT testing, enteric dysbiosis evaluation, and metabolomics (blood/urine) experimental/investigational and not covered.

"HCPCS/Codes not covered (selected list): C9723 (DIRI), G0237 (breathing retraining), J0133 (acyclovir injection) and a long list of J-codes for immune globulins, steroids, rituximab (J9312), ondans..."

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