Wiki Aetna Anesthesia Policy

[sbarrila]

Does anyone know if Aetna has changed their Anesthesia policy for Colonoscopies & EGDs? There was talk of them no longer allowing MAC back in 2008 but they did not actually put the policy through. Has anyone received denials from Aetna for anesthesia for these same services because a patient was not high risk? Thank you!

 

[jdrueppel]

sbarrila,

I bill for a 40 provider group in Lincoln NE - I have not experienced any Aetna denials to date.

Julie D, CPC

 

[bdobyns]

I work for a 10 provider GI & ASC and routinely will bill Aetna for anesthesia with no issue.

 

[NIENAJADLY]

Aetna EGD/Colonoscopy denials

We have received a couple denials recently. I think some braniac at Aetna found the 2006 tentative policy (they rescinded it, never put it into place) and started applying it in error. One of our insurance girls had it sent back through and they admitted they denied in error, got it paid but not sure if Aetna is bringing it back in force or if it's just one or two adjusters who have their wires crossed.

We're in FL, btw.

Kellie

 

[fuga]

Haven't seen any MAC denials recently. Although Aetna is famous for only paying 1-unit of anesthesia and hoping no one notices. They are aware of the issue but can not find a way to fix it. In other words, not enough complaints to try to fix.