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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 | Medical Billing and Coding Forum - AAPC Aetna breast cancer patient had delayed reconstruction so the doctor inserted bilateral implants 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?
AETNA and G2211 | Medical Billing and Coding Forum - AAPC I have heard that AETNA will no longer reimburse for the G2211 code, but I can't find any specific policy bulletin about this Has anyone else heard this and can point me to the specific policy? Thanks
CPT® Code 64454 - AAPC The Current Procedural Terminology (CPT ®) code 64454 as maintained by American Medical Association, is a medical procedural code under the range - Introduction Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures on the Somatic Nerves
Wiki - 36415 denials | Medical Billing and Coding Forum - AAPC My claims for Cigna and Aetna are being denied for the 36415 when performed with an office visit the lab bills the lab tests, we bill the venipuncture Is anyone out there getting paid for the 36415 for these insurance companies?
Wiki - 76830 and 76856 | Medical Billing and Coding Forum - AAPC 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 When a 59 is appended to the bundled code (which goes against coding guidelines) the once-bundles denied code is paid
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)
Wiki - Aetna downcoding of E M claims - AAPC Is anyone else noticing Aetna E M claims being randomly downcoded without any justification? We have had many 99214 downcoded to 99213, even though the MDM supported the 99214 If you are experiencing this and likely appealing, have you had any success in getting these decisions overturned?
Wiki - CPT 81003 inclusvie denieal from Aetna. - AAPC Hi all, 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