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1, 2025, unless congress acts. 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 In 2024 and previously at our psychiatric office for medication management and therapy, our providers, all mds and nps, would code a typical 30 minute visit as 99214, 90833 for an e/m with the psychotherapy add on
Whenever this was completed by a video we would also add the telemedicine 95. After appeals and disputes with provider representatives and medical directors, aetna refused to accept 77014 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
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? We had a claim for 99222 that was denied by aetna since another provider had billed for it first They are claiming that the code can only be billed once per day
I checked again and cms. 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? 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.
Aetna 77387 reimbursement rate we had the same issues with aetna not accepting 77014
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