Hello, I have an Aetna denial for a fracture situation I've never seen before. Our doctor saw a patient who presented to ER the day prior for humerus fracture. They took x-rays and gave a sling. Our doctor evaluated and prescribed meds, and ordered a CT to determine fracture care vs ORIF vs TRSA. Pt had CT and came back the next day to review results, and decided to do fracture care.
We billed it like this:
Initial visit
99204
F/u visit
99214-57
23600
Aetna denied both E/Ms as global and paid the fracture care. Did we bill everything correctly based on the situation? If so, what would we need to appeal both office visits?
We billed it like this:
Initial visit
99204
F/u visit
99214-57
23600
Aetna denied both E/Ms as global and paid the fracture care. Did we bill everything correctly based on the situation? If so, what would we need to appeal both office visits?