lindam@caricures.com
Networker
Is anyone else having a problem with Aetna/Medicare paying for High Risk Screening colonoscopies? I have had multiple denied in 2025. They are denying stating benefit maximum for time period had been reached. Policy benefits have been exhausted. On aetna's website they state surveillance colonoscopy on high risk patients can be done every 24 months. The ones I am not getting paid for have all been at about 3 years. I've done reconsideration, and exhausted appeals. I am trying to work with an Aetna rep to get it straightened out, but it is taking forever. Just wondering if anyone else is having this issue and how did you resolve it?
G0150 Dx: Z12.11 - Encounter for screening colonoscopy. Z86.0101 Personal history of adenomatous polyps. I've sent operative reports and pathology reports.
G0150 Dx: Z12.11 - Encounter for screening colonoscopy. Z86.0101 Personal history of adenomatous polyps. I've sent operative reports and pathology reports.