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  • Wiki - Aetna denying G2212 stating this is an add on code
    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 Add-on codes
  • 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 - AETNA and G2211 | Medical Billing and Coding Forum - AAPC
    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
  • 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 - 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
  • For Chiropractors: Know 97140 Billing Rules - AAPC
    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
  • Wiki - BCBS and Aetna bundling 90480 | Medical Billing and . . . - 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
  • CPT® Code 90472 - Immunization Administration for Vaccines . . . - AAPC
    The Current Procedural Terminology (CPT ®) code 90472 as maintained by American Medical Association, is a medical procedural code under the range - Immunization Administration for Vaccines Toxoids
  • Wiki - 20610 Aetna denying for experimental or investigational . . . - AAPC
    I have gotten several denials from Aetna recently denying 20610 as investigational or experimental The diagnosis codes being used are M17 11 and M17 12
  • 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





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