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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
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
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
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)
CPT® Code 64454 - AAPC The Current Procedural Terminology (CPT ®) code 64454 as maintained by American Medical Association, is a medical procedural code under the range - Introduction Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures on the Somatic Nerves
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 - Aetna downcoding of E M claims - AAPC Is anyone else noticing Aetna E M claims being randomly downcoded without any justification? We have had many 99214 downcoded to 99213, even though the MDM supported the 99214 If you are experiencing this and likely appealing, have you had any success in getting these decisions overturned?