Wiki G2211 and Aetna Medicare

[ddistano@maronrodmd.com]

Aetna Medicare is only paying us 1 penny for G2211. That's right. $0.01

Is anyone else experiencing this? What is everyone else getting paid on G2211 from Aetna Medicare?

 

[Lorisvg]

After seeing your question, I checked our reimbursement, and we are also being paid $0.01. We called, and the rep I spoke with advised the payment amount for G2211 is based on medical necessity. The base pay for this code without appropriate medical records is $0.01, but can potentially be paid more based on the medical necessity. I was advised that when these claims are submitted to Aetna Medicare, we want to be sure we include of course all medical records, a diagnosis list (also known as the problem list), medical history and anything that can support additionally why this code should be covered at a higher compensation.

This seems awful bold of them.

 

[jkyles]

The Texas Medical Association met with Aetna about this last year. It looks like Aetna didn't fix it after all. https://www.texmed.org/Template.aspx?id=64660

 

[ddistano@maronrodmd.com]

Good to know we are not the only ones. I have tried to fight them tooth and nail on this but they are not budging!