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Thread: Aetna 77003

  1. #1
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    Default Aetna 77003

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    Has anyone had difficulty getting 77003 and of course 77002 paid with their injections? They keep bundling the fluoro and there is no policy on their website.

  2. #2
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    Apr 2007
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    Default

    Aetna has a way of coming up with some unique denials. I would have a standard way to appeal them Like a letter that addresses why the fluoro is not bundled. In the current issue of Coding Edge, in the article for transforaminal injections, the writer of the article, mentions the link/article from ASA the fact that fluoro is not bundled into certain injections.

    http://www.asahq.org/news/031907Fluoroupdate.pdf

    I think this is the link he mentions.

    Another thing to look at is that you mentioned 77002. Nowadays, 77002 is bundled in a lot of codes such as many from this range 64400-64450, 64520, 64510. That might be something to look at.

    For 77003, it should be separately reportable with 62273,62310,62311,64479-64484,64622,64623,64626,64627. And 27096 these are the codes that come to mind, where an appeal would be necessary if they want go the route they are when processing.

  3. #3
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    Apr 2007
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    Default

    Yes Aetna is very good at unique denials...thanks.

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