2019年5月24日 · Their new policy states FOR ALL PLANS "We allow 1 of this group of codes per patient per day across all providers based on CMS guidelines." CPT codes 99234-99236, 99238-99239 & 99221-99223. Line above is taken from Aetna's policy. We only have one NP in our practice and we don't bill anything with her. Their denials are nonsense.

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.

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.

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.

2015年11月12日 · I'm looking for a simple plain english definition of what the heck 835 Healthcare Policy Identification Segment denial code actually means, and what loop 2110 REF is and where to find these things I'm supposed to be able to refer to. I've attached an example of a common 835 denial code description. Any help is appreciated, thanks

2020年6月3日 · What I found says they can both be billed, but that Aetna will deny the pelvic ultrasound as incidental to the transvag ultrasound, effective 12/1/2012. I couldn't find anything in their Medical Clinical Policy Bulletins, but they might have it somewhere in their other policies.

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.

2021年11月4日 · I would recommend asking Aetna for their policy. If you are participating, and this is an Aetna policy ...

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.

2021年10月5日 · Almost all my contracts specify CMS guidelines when there are differing guidelines. You should check your contract or see if Aetna has a policy on this. For 99202-99205, it is certainly feasible and reasonable for a patient to see a new gastroenterologist in the morning, and a new cardiologist later that same day.