Payer PolicyActive
Anesthetic and Antiemetic Infusion Pumps
AETNA-CPB-0607
Aetna
Effective: August 31, 2023
Updated: December 6, 2025
created · Dec 2, 2025
Policy Summary
Aetna considers anesthetic and antiemetic infusion pumps—including intralesional, local wound, intra‑articular, and continuous subcutaneous antiemetic pumps—experimental and investigational and therefore not covered for the listed postoperative uses (e.g., arthroscopic shoulder procedures, rotator cuff repair, knee arthroscopy, ACL reconstruction, total knee arthroplasty, and multiple other surgical indications). No indications are covered and no coverage requirements are provided, as Aetna states effectiveness has not been demonstrated.
Coverage Criteria Preview
Key requirements from the full policy
"Some randomized controlled trials show no additional analgesic benefit compared with placebo for certain continuous infusion applications (examples include intra‑articular morphine/bupivacaine afte..."
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