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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?
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
Billing Medicare for Telehealth Services in 2024 - AAPC The Centers for Medicare Medicaid Services (CMS) made several substantial changes to its payment policy for telehealth services furnished to Medicare beneficiaries on or after Jan 1, 2024 Healthcare providers should be aware of the changes to ensure proper claims reporting and reimbursement Medicare Telehealth Code List Update The list of telehealth services houses all the services
Telehealth Services After the PHE - AAPC Knowledge Center Facts About Coverage Post PHE Here are some highlights of what is changing on May 11, 2023, (or later) for telehealth services billed under Medicare Part B: Virtual check-in codes (G2012, G2010, G2252) and remote patient monitoring codes will only be allowed for established patients after the PHE ends Medicare will continue to pay for audio-only telephone services billed with CPT® codes
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
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
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)
Billing for NP practice | Medical Billing and Coding Forum - AAPC Hi! I will be billing for an NP-owned practice, which is composed of two NP's and a physician Aetna will not credential the NP's because they are not employees of the physician (The physician is credentialed with Aetna ) If one of the NP's sees an Aetna patient and uses their NPI, will