Wiki AETNA MEDICARE ADVANTAGE WWE

[SDELOSSANTOS1]

I HAVE A PATIENT THAT CAME IN FOR WELL WOMAN EXAM WITH AETNA MEDICARE AND WE BILLED 99397 WITH DX Z01.419, Z12.4, AND Z11.51; THE BENEFITS QUOTED STATED WWE IS ALLOWED EVERY 12 MONTHS BUT WHEN THE CLAIM PROCESSED IT WAS DENIED FOR BENEFITS EXHAUSTED. I HAVE HAD THIS CLAIM SENT BACK 4 TIMES AND IT DENIES EVERY TIME. MY QUESTION IS, WAS IT BILLED CORRECTLY THE FIRST TIME OR DOES AETNA MEDICARE ADVANTAGE REQUIRE DIFFERENT CODES?

 

[baskiles]

Did the patient already have a WWE by another provide within the past 12 months?