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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 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
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?
Bill G2211 With Confidence (and Modifier 25) - AAPC Providers and patients both reap the benefits when this add-on code is used correctly HCPCS Level II add-on code G2211 recognizes the ongoing Providers and patients both reap the benefits when this add-on code is used correctly
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
New Telemedicine Codes for 2025 - AAPC For the Current Procedural Technology (CPT®) 2025 code set, a new Telemedicine Services subsection with 17 new codes has been added to the Evaluation and Management (E M) section These 17 new codes are intended for reporting synchronous (ie, real-time) E M services, with coding options available for both new and established patients This article provides guidance on these new guidelines and
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
Modifier 50 vs LT RT | Medical Billing and Coding Forum - AAPC I usually use modifier 50: the procedure code billed on two lines with modifier 50 on the second line Reimbursement has been correct so far Aetna accepts either way This was published in one of their monthly newsletters Hope this helps But like everyone else has stated, it is important to check with your individual carriers for your area
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?