Aetna denying 96132 and 96136 when billed with 99215

[eldinadedic]

Aetna insurance denied CPT codes 96132 and 96136, but paid 99215.
They were billed as:
99215
96132 -59
96136 -59

DX: F84.0, F80.9, F82, F88

Per CCI edit modifier 59 can be billed with these codes. Aetna is stating that these codes are not supported by modifier 59.
We are pediatric neurologist office, and do this testing all the time, other insurances are paying.
If anyone is billing these please let me know how you're billing for it. Thanks.

 

[sls314]

Aetna insurance denied CPT codes 96132 and 96136, but paid 99215.
They were billed as:
99215
96132 -59
96136 -59

DX: F84.0, F80.9, F82, F88

Per CCI edit modifier 59 can be billed with these codes. Aetna is stating that these codes are not supported by modifier 59.
We are pediatric neurologist office, and do this testing all the time, other insurances are paying.
If anyone is billing these please let me know how you're billing for it. Thanks.

Does Aetna want the X modifiers instead?

The X modifiers are more specific. I rarely if ever use Modifier 59. Only if a payer specifically wants 59.

Otherwise, I go with an X modifier for the added specificity.