37242 CPT® code: payer coverage and prior authorization28 of 34 payer prior-auth lists that name 37242 require prior authorization or set conditions: CarePlus Health Plans, Cigna, Humana, Molina Healthcare of California, Molina Healthcare of Illinois, Molina Healthcare of Michigan, Molina Healthcare of Ohio, Neighborhood Health Partnership, Oxford Health Plans, UnitedHealthcare.
37242 appears in 17 coverage policies from Aetna, Blue Cross NC, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Ablation of Hepatic Lesions (0274) | not covered | Jun 8, 2026 | payer document |
| Aetna | Anesthetic and Antiemetic Infusion Pumps (0607) | listed, no stance (range 33016-37799) | Sep 9, 2026 | payer document |
| Aetna | Benign Prostatic Hyperplasia (0079) | not covered | Apr 15, 2026 | payer document |
| Aetna | Bupivacaine Liposome (Exparel) (0941) | listed, no stance (range 33010-37799) | Jul 30, 2026 | payer document |
| Aetna | Cardiovascular Ultrafiltration (0741) | listed, no stance (range 33010-37790) | Oct 30, 2025 | payer document |
| Aetna | Embolization: Selected Procedures (0856) | covered if criteria are met | Jan 12, 2026 | payer document |
| Aetna | Endovascular Repair of Aortic Diseases (0651) | not covered | Sep 25, 2026 | payer document |
| Aetna | Grid Monitoring and Intraoperative Electroencephalography (0289) | listed, no stance | Apr 17, 2026 | payer document |
| Aetna | Knee Arthroscopy / Osteoarthritis of the Knee (0673) Balneotherapy, Advanced Arthritis Relief Protocol, high-intensity laser therapy, pulsed vibration therapy, xeno-matrix-induced chondrogenesis - | not covered | Feb 19, 2026 | payer document |
| Aetna | Liver and Other Neoplasms - Treatment Approaches (0268) | covered if criteria are met | Sep 18, 2026 | payer document |
| Aetna | Negative Pressure Wound Therapy (0334) | listed, no stance (range 33016-37799) | Jun 8, 2026 | payer document |
| Aetna | Nitric Oxide, Inhalational (INO) (0518) | not covered (range 33016-37790) | Jul 2, 2026 | payer document |
| Aetna | Peripheral Atherectomy and Thrombectomy Devices (0295) | covered if criteria are met (range 37220-37247) | Apr 16, 2026 | payer document |
| Aetna | Stereolithographic Models and Implants (0613) | listed, no stance (range 33010-37790) | Sep 3, 2026 | payer document |
| Aetna | Ultrasound Guidance – Selected Indications (0952) | not covered | Apr 27, 2026 | payer document |
| Blue Cross NC | Congenital Heart Defect, Repair Devices | listed, no stance | Jun 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Genicular Artery Embolization (SUR705.048) | listed, no stance | Jul 15, 2025 | payer document |
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.