92250 & 92285

veeramani14

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Hi Everyone, Am getting issues with 92250,92285 codes, frequently am getting denials for these cpt as "Procedure/treatment is deemed experimental/investigational by the payer"

can anyone help me out.?
 

lcathey@smsc.org

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92285

I realize this is a very old post, but I get that reason a lot from MA Aetna and Aetna. They seem to be quicker to deem something experimental or not necessary. They have a pretty limited amount of covered diagnosis. I have attached the link for the most recent Aetna/MA Aetna guidelines. I could not find an LCD or NCD for Texas on Novitas.

http://www.aetna.com/cpb/medical/data/700_799/0734.html

Good luck and I hope this helps someone!
 
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