cennist
New
Has anyone been getting denials from Aetna when billing 64405? Aetna considers it experimental and investigational. What documentation are you sending to prove otherwise? Thanks
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki 64405 Denial as experimental for treatment of cervicogenic headache
- Thread starter cennist
- Start date
danskangel313
True Blue
- Messages
- 810
- Best answers
- 0
Aetna specifically excludes this procedure for this diagnosis. I don't think they will ever pay, no matter how much documentation you send them.
See: http://www.aetna.com/cpb/medical/data/700_799/0707.html
Melissa Harris CPC
Expert
Occipital Nerve Blocks are not covered by Aetna or United Health Care. Patient may sign an ABN and pay for out of pocket.
Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management
Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management
Ajillani
Guest
do we know if this has changed? I have a UMR denial for this code and it being experimental.
Melissa Harris CPC
Expert
UMR follows UHC I believe. You can pull up the UMR policy on Optum