How do I bill for prenatal care?
Primary care physicians providing only prenatal care should bill for the prenatal visits they have provided using CPT Code 59425 (antepartum care only; 4 to 6 visits) or CPT Code 59426 (antepartum care only; 7 or more visits), and will be reimbursed according to Aetna’s fee schedule.
Does Aetna cover CPT 99358?
Prolonged physician services 9/1/2011 Aetna does not pay for medical services without direct patient contact; thus, procedure codes 99358 and 99359 will be denied.
Does Aetna pay for consultation codes?
But United Healthcare has a new payment policy that allows payment for consultations. Other payers, including Cigna, Aetna, and Anthem, do cover consultations in most states.
How do you code OB visits?
Use CPT Category II code 0500F (Initial prenatal care visit) or 0501F (Prenatal flow sheet documented in medical record by first prenatal visit). Date of postpartum visit – The postpartum visit should occur 4-6 weeks after delivery. Use CPT II code 0503F (postpartum care visit) and ICD-10 diagnosis code Z39.
How does Aetna want bilateral procedures billed?
Bilateral surgical and nonsurgical procedures are reported as a single code billed (1) with modifier 50, (2) twice on the same day with RT and LT modifiers, or (3) with 2 units. For Medicare plans, Aetna pays 150% of the fee schedule amount for a bilateral surgical procedure.
What are the medical policy bulletins for Aetna?
Explore the medical clinical policy bulletins that Aetna uses to decide which services and procedures we will cover. Medical Clinical Policy Bulletins – Health Care Professionals | Aetna Skip to main content Aetna.com works best with Internet Explorer 11 and above, and does not work in compatibility mode.
Can a Gynecological Ultrasound be performed with Aetna?
(HMO, Aetna Health Network Only plans and Aetna Health Network Option plans) Gynecology ultrasounds (for example, CPT codes 76830, 76831, 76856 and 76857) may be performed in the Ob/Gyn office without a referral or prior authorization. These are reimbursed on a fee-for-service basis.
Who are Aetna specialty institutes and aexcel performance network?
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Where can I get an Aetna Member ID card?
Instead of a plastic ID card, your patients may give your office: Please accept these alternate formats. You can get a patient’s digital member ID card by submitting an eligibility inquiry on our secure provider website, or through Availity. ID cards can be saved and printed. Electronic transactions can save you time.