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Wiki Aetna Medicare C9871

sxcoder05

Networker
Messages
33
Location
Topeka, KS
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We filed a claim to Aetna Medicare for CPT Code C9871 after the website states:
The procedure code you entered was not found on the Aetna Participating Provider Medical Precertification List. If you’re a participating provider, no precertification is required when this service is performed as an outpatient procedure for a medical or surgical diagnosis. This procedure code may require precertification for behavioral health diagnoses.

Aetna denied they claim stating we don't cover health care services and procedures that aren't proven to be effective.

The Claim was filed with C9871 as the primary code, along with 29827 and 29824. When they processed the claim, 29827 and 29824 were discounted for multiple procedures.

Has anyone else filed CPT Code C9871 and had their claim deny? Also, why would the 2 other codes only pay at 50% if they denied C9871.
 
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