Wiki Consultation Codes for Aetna


Waconia, MN
Best answers
Good Morning,
Does anyone know if Aetna is still accepting Consultation codes? I haven't seen anything that states that they have stopped accepting them.

I have billed an outpt consult with code 99243 and have received the denial "Submit using a E&M code appropriate for service."

Has anyone else had this denial?

Thanks for the help!
Missy, from what I've discovered if it's Aetna typical commercial plans, then I think the consult codes are still good to go. But if it involves their MCR advantage type plans, then NO, do not as they follow MCR guidlines. And IF AETNA renounced the consult codes, my guess would be that it was done starting the the first of the year. Maybe some others will comment as I'm just not 100% positive...
---Suzanne E. Byrum CPC