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  • 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
  • aetna - AAPC
    Does anyone know if Mental health providers (psychologist trist) can bill 96127? We used to bill it with a 90846 or 90847 years ago, but we now know they are bundled Has anyone b
  • 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
  • AETNA AND MODIFIER 78 | Medical Billing and Coding Forum - AAPC
    Is anyone having issues with billing Modifier 78 for Aetna insurance? We billed a ESWL in January and we were paid, and then patient went back for another ESWL almost 3 weeks later that was unplanned and necessary Aetna has denied the latter surgery as not allowed during a global surgery fee
  • Wiki - Aetna Denial for 20611 as experimental - AAPC
    We are seeing Aetna denials for 20611 as experimental No other payer has this denial Has anyone had any luck with appealing these with Aetna or is this a true denial Their policy for Aetna MA are pointing to a commercial policy
  • Wiki - Commercial Payors Screening colonoscopy turns diagnostic . . . - AAPC
    For ALL commercial policies screening to diagnostic is 00812 with PT The only time you would use 00811 on a screening turned diagnostic for a commercial payor is if they have a previous history of polyps (z86 010) Currently Aetna, UHC and Cigna are all wanting 00811 NO PT mod with z1211, z86010, but BCBS for example will still take the 00812 PT in this scenario However @TThivierge is
  • 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
  • Part B Insider (Multispecialty) Coding Alert - AAPC
    Example: Aetna lists several diagnoses that may prove medical necessity, such as 627 2, (Symptomatic menopausal or female climacteric states) and 733 90 (Disorder of bone and cartilage, unspecified)
  • 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
  • 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





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