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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 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)
  • 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
  • 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 - 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
  • 95165 and Aetna | Medical Billing and Coding Forum - AAPC
    We have been getting denials from Aetna insurance when billing our 95165 They state you can only bill 120 units for 95165 in a 365 day period or 30 every 3 months If we use our 120 units and still have serum to make and bill can we switch to billing 95125 even though their serum is
  • Medical Coding Billing Tools - CPT®, ICD-10, HCPCS Codes . . . - AAPC
    Online medical coding solutions: Codify by AAPC easy CPT®, HCPCS, ICD-10 lookup, plus crosswalks, CCI, MPFS, specialty coding publications webinars
  • INCIDENTAL DENIALS | Medical Billing and Coding Forum - AAPC
    This thread is specifically about Aetna, Aetna denials on wax removal and thread 69210 all of sudden being denied as global mentions Aetna in addition to Cigna denying these services





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