Wiki Aetna denials

[Jennifer George]

Hello- within the past few months we have been receiving denials on our hospital billing codes. We are not the attending/admitting doctor but we are consulted to see patients. Since Aetna does not accept consult codes we bill for example a 99222. This is denied and when we call they say another doctor from another practice has already billed this code and that we need to add a modifier????? Any ideas on what mod this could be??

 

[mitchellde]

the admitting provider must use an AI modifier on their initial level for the admit. without this the consulting providers cannot be paid. You will need to contact the admitting provider office to have them rebill their claim if already billed using the AI modifier.