May 24, 2019 · 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 …

Feb 12, 2025 · 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 …

Oct 17, 2025 · 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 …

Jul 15, 2024 · 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

Apr 13, 2023 · 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 …

Nov 4, 2021 · I called Aetna and was told they pay the first provider that sends in their claim with this code no matter how many consulting doctors there are. I know they do not recognize consult codes …

Dec 3, 2025 · 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 …

Nov 20, 2025 · Hi everyone: We had a patient (Aetna coverage) who had antepartum care that crossed over the 2024/2025 year change. She had four antepartum visits, so it was billed with 59425. There …

Jul 13, 2017 · 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 …

May 1, 2025 · Is anyone having issues with billing Modifier 78 for Aetna insurance? We billed a ESWL in January and we were paid, and then patient went back for another ESWL almost 3 weeks later that …