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Infusion Pump - External · Order types

Order types
Infusion Pump - External

Infusion Pump - External

· Updated Sep 1, 2026

Insurance payer

Aetna

Service line

Positive Airway Pressure (PAP) Devices

Linked policies

Plan type

—

PBM

—

Classification

INITIATION

Diagnosis codes

Z99.89

States

—

Required documents

None

Criteria

None

Accessory codes

E0781

Required documents

None

Criteria

None

Accessory codes

E0781

E0781

None linked