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- aetna | Medical Billing and Coding Forum - AAPC
Aetna breast cancer patient had delayed reconstruction so the doctor inserted bilateral implants I coded 19342 with modifier 50 and aetna only paid for one side, do i need to bill with rt and lt modifiers to receive proper reimbursement?
- Aetna E M Policy | Medical Billing and Coding Forum - AAPC
Now, I couldn't find Aetna's E M policy, but I would be very surprised if they decided to deviate too much on that sense Possible reasons for the denial: -The patient was seen by the same provider at a previous practice, within 3 years -The patient was seen by a similar credentialed provider from the same practice (fairly common denial reason)
- Wiki - BCBS and Aetna bundling 90480 - AAPC
BCBS and Aetna are bundling CPT code 90480 (COVID vaccine administration) when billed with COVID vaccine codes 91321 or 91322 AND a flu vaccine (90656) with vaccine admin code 90460 If we bill if we bill 90480 and 91321 (or 22) alone, the 90480 is paid This bundling issue just started in
- Wiki - AETNA and G2211 | Medical Billing and Coding Forum - AAPC
I was also researching as the big commercial insurances have and or are in the process of adding policies specific to G2211 - Here is what I located from Aetna- Hope this helps
- Wiki - Aetna denying G2212 stating this is an add on code
We billed 99215 and G2212 (Prolonged out patient office visit) to Aetna (since provider spent more than 55 minutes) but they paid for 99215 and denied G2212 stating "This claim is being denied for one of two reasons: - We did not receive a claim for the primary service performed Add-on codes
- Aetna denying 99214-93 for audio visit only - AAPC
Hello! Aetna has been denying our telehealth visits billed with modifier 93 when the video connection fails and the visit is completed as audio-only (99214-93) I called and spoke with a representative who confirmed that Aetna is no longer accepting modifier 93 He advised us to use modifier 95
- Aetna and antepartum care | Medical Billing and Coding Forum - AAPC
Hi everyone: We had a patient (Aetna coverage) who had antepartum care that crossed over the 2024 2025 year change She had four antepartum visits, so it was billed with 59425 There was no plan coverage group change for the new year Aetna is denying it wanting it to be broken out by year
- 99221-99223 denials | Medical Billing and Coding Forum - AAPC
We had a claim for 99222 that was denied by Aetna since another provider had billed for it first We are the attending physician (and was the one who asked for a consult with the other provider) so I appended the modifier -AI, sent in the corrected claim with reconsideration form but they still denied it They are claiming that the code can only be billed once per day I checked again and CMS
- Wiki - Billing Radiation Therapy Codes 77301 and 77014
Aetna 77387 reimbursement rate We had the same issues with Aetna not accepting 77014 After appeals and disputes with provider representatives and medical directors, Aetna refused to accept 77014 The reimbursement for 77387 is significantly less than 77014, therefore, we came to an agreement to bill 77387, and Aetna agreed to reimburse 77387 with a rate comparable to 77014 An amendment was
- Wiki - Billing hydration services J7030, J7040? - AAPC
Good afternoon, Recently we started receiving denials from Aetna (no other payers at this time) stating that when we are billing hydration services 96360, 96361 we are not allowed to bill the saline solution J7030, J7040 as they are bundled with the procedure We have not had issues with this
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