2023年5月1日 · Just an FYI to the article from the author: The use of the -93 modifier is currently active, but optional. CMS has stated that the -95 modifier is for Telehealth services through 2024, due to payment parity.

2024年11月8日 · Medicare reinstates certain pre-pandemic telehealth policies. COVID-19 public health emergency waivers that applied to Medicare Part B policies for The 2025 PFS final rule is the final word for telehealth services effective Jan. 1, 2025, unless Congress acts.

2019年5月24日 · 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)

2021年10月5日 · Hello All, We are getting denials for the codes 99203-99205 outpatient office/hosp. and 99221-99223 inpatient, Aetna is stating they only pay 1 provider of this group of codes per patient per day across all providers.

2013年7月2日 · Can you please share me the Aetna Insurance policy details, which state we can only bill 120 units for 95165 in a 365-day period or 30 every 3 months but found this for Allergy test but no information about serum mix. Number: 0038 (Replaces CPB 326) 0038-Allergy Testing and Allergy Immunotherapy; Thank you.

2022年10月20日 · Sometimes it gets denied but then will go through after appending the 59-mod to it. If the corrected claim gets denied, then I submit an appeal with medical records; but lately even with the appeal it's been getting denied. It's a hit or miss. If all else fails, I call Aetna directly and have them send it back to be reviewed.

2019年8月8日 · 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.

2017年11月11日 · Aetna insurance frequently denying CPT 81003 or 81002 charges as inclusive with E&M service (99201-99395). Initially I tried with modifier “25” to E&M, after that I even tried with an appeal, but no use, it denied as inclusive again. In this case I need clarification that, is there any payer policy in Aetna website regarding this.

Through Dec. 31, 2024, there are no geographic restrictions for patients or providers. For Medicare, use the place of service code that identifies where the patient is located: POS 02 when the patient is not at home or POS 10 if the telehealth is provided in the patient’s home.

2023年1月3日 · A thorough understanding of the latest guidelines for coding evaluation and management services is necessary to ensure compliant claims. You’ve likely A thorough understanding of the latest guidelines for coding E/M services is necessary to …