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  • Telehealth 2025: The Final Rule - AAPC Knowledge Center
    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
  • 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)
  • Telehealth Services After the PHE - AAPC Knowledge Center
    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
  • Billing Medicare for Telehealth Services in 2024 - AAPC
    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
  • Wiki - 76830 and 76856 | Medical Billing and Coding Forum - AAPC
    per Encoder these 2 codes are not bundled The report combines the findings into one but is clearly two approaches The insurance I am having an issue with is Aetna They are inconsistent however always bundle one into the other and only pay for one-sometimes the transvag and sometimes the pelvic ultrasound
  • CPT® Code 64454 - AAPC
    CPT Code 64454, Introduction Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System, Introduction Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures on the Somatic Nerves - Codify by AAPC
  • Wiki CPT 81003 inclusvie denieal from Aetna. - AAPC
    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
  • INCIDENTAL DENIALS | Medical Billing and Coding Forum - AAPC
    If you search the forums for Aetna and 69210 you'll find multiple threads reporting issues with Aetna denying 69210 with an E M billed with modifer 25 This seems to be some type of policy Aetna has instituted in the last year or so I don't think that anything has changed and Aetna is still denying the 69210 billed with an E M with modifier 25
  • 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
  • Medical Coding Billing Tools - CPT®, ICD-10, HCPCS Codes . . . - AAPC
    Online medical coding solutions: Codify by AAPC easy CPT®, HCPCS, ICD-10 lookup, plus crosswalks, CCI, MPFS, specialty coding publications webinars





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