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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)
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?
Wiki - Psychotherapy codes w new Telemedicine Synchronous Audio . . . - AAPC In 2024 and previously at our psychiatric office for medication management and therapy, our providers, all MDs and NPs, would code a typical 30 minute visit as 99214, 90833 for an E M with the psychotherapy add on Whenever this was completed by a video we would also add the telemedicine 95
Wiki - Telehealth visits and modifier for 2025 - AAPC Hello all, for the new CPT codes for audio only telehealth visits using POS 10, do we need to use modifier 93? Do we also use modifier 93 for straight Medicare telehealth visits as well?
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
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
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
Wiki - Billing Radiation Therapy Codes 77301 and 77014 Aetna 77387 reimbursement rate We had the same issues with Aetna not accepting 77014 After appeals and disputes with provider representatives and medical directors, Aetna refused to accept 77014 The reimbursement for 77387 is significantly less than 77014, therefore, we came to an agreement to bill 77387, and Aetna agreed to reimburse 77387 with a rate comparable to 77014 An amendment was