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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? Bcbs pays with modifier 50 We don't have many aetna
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
2025 Brings New Telemedicine Codes - AAPC Knowledge Center E M services for new patients (98000-98003) E M services for established patients (98004-98007) The selection of these new telemedicine E M codes is based on either total time spent on the date of service or medical decision making (MDM)
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: Medicare Policy for CY 2025 - AAPC Rulemaking and lawmaking keep telemedicine a viable solution for the masses, for now Now that the dust has settled on the American Relief Act, 2025, Medicare policy for telehealth services is extended through March 31, but then what?
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
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
Downgrading E M services | Medical Billing and Coding Forum - AAPC Aetna has a downgrading policy that they base the level of service on what's provided on the claim - if there's something in documentation that substantiates the level of service, appeal What CSperoni said above FYI - Aetna is not the only payer with a downgrading policy for Level 4 and 5 visits
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