P2P Call Guide

How to Win a P2P Call for Hysterectomy Denied by Aetna

Payer-specific strategy, medical necessity arguments, and the exact phrases to use when Aetna denies Hysterectomy (CPT 58571, 58573, 58150).

Why Aetna Denies Hysterectomy

Conservative management not exhausted (hormonal therapy, ablation)

Uterine size does not meet threshold

Alternative less invasive procedures not tried

Know Aetna's Criteria

Aetna uses their own Clinical Policy Bulletins (CPBs) and InterQual criteria. CPBs are publicly available and numbered.

Key policies to know:

  • Clinical Policy Bulletins (CPBs) are publicly available and numbered
  • Uses eviCore for radiology and cardiology prior auth
  • Known for detailed, evidence-based CPBs with specific criteria
  • Precertification list updated annually

Building Your Medical Necessity Argument

Document failure of hormonal management

Note uterine size and symptom severity

Explain why less invasive alternatives are not appropriate

Reference impact on quality of life and functional status

P2P Call Tips for Aetna

Reference the specific CPB number and criteria being met

Aetna CPBs are very detailed -- read them before the call

Address each specific criterion in the CPB during the P2P

Aetna medical directors are typically receptive to guideline-based arguments

Guidelines to Reference

  • ACOG Practice Bulletin on Hysterectomy
  • AAGL Practice Guidelines for Hysterectomy

Relevant CPT Codes

CPT 58571CPT 58573CPT 58150

Specialty: Gynecology

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