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)
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 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 ...
Hello! Aetna has been denying our telehealth visits billed with modifier 93 when the video connection fails and the visit is completed as audio-only. (99214-93) I called and spoke with a representative who confirmed that Aetna is no longer accepting modifier 93. He advised us to use modifier 95...
We recently starting seeing Aetna deny complex repair CPT Codes 13101 etc. They will pay the excision and then deny the repair. We submit medical records, and its still rejecting or they are taking over 90 days to respond. We even include the pathology report, site photos that clearly show...
Wiki - Aetna - Complex Repairs w Exc of Benign lesion - AAPC