Aetna foundation cultivating healthy communities 2018. May 24, 2019 · Now, I couldn't...
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Aetna foundation cultivating healthy communities 2018. May 24, 2019 · 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. Add-on codes Nov 20, 2025 · Hi everyone: We had a patient (Aetna coverage) who had antepartum care that crossed over the 2024/2025 year change. Aetna is denying it wanting it to be broken out by year Jul 1, 2014 · Aetna has made a nationwide policy decision for chiropractic reimbursement, which states that when manual therapy (97140 Manual therapy techniques, one or more regions, each 15 minutes) is performed on the same date of service (DOS) as a chiropractic manipulative treatment (98940-98943), the manual therapy will be denied, automatically. He advised us to use modifier 95 May 1, 2025 · 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. 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? Jul 15, 2024 · 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 Oct 17, 2025 · 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. 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) Feb 12, 2025 · Aetna breast cancer patient had delayed reconstruction so the doctor inserted bilateral implants. Aetna has denied the latter surgery as not allowed during a global surgery fee Nov 4, 2021 · I called Aetna and was told they pay the first provider that sends in their claim with this code no matter how many consulting doctors there are. This bundling issue just started in Apr 13, 2023 · 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. She had four antepartum visits, so it was billed with 59425. (99214-93) I called and spoke with a representative who confirmed that Aetna is no longer accepting modifier 93. How do all of the other consulting doctors get paid?. There was no plan/coverage/group change for the new year. How do all of the other consulting doctors get paid? May 24, 2019 · 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. I know they do not recognize consult codes 99243, 99244, and 99245 and the admitting doctor should add the AI modifier to the 99221, 99222, or 99223. Dec 3, 2025 · 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.
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