Is anyone else having problem with Aetna bundling the urine test?
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Clia 81003
So I received a denial for an ER pt on CPT code 81003 which had a (XU mod appended), saying that the modifier appended got denied. I looked online and per CLIA instead of mod XU I can put mod QW? It is a simplified test and the test is CLIA approved.
Billing 81002 or 81003
We have recently begun to get a lot of rejections for the 81002 code, especially from BCN and of course Medicare. Can anyone help getting 81002 paid by Medicare? Is 81003 a better payable code?
And BCN states it needs to be billed with CLIA waived modifier which we have but they are still getting denied. I have tried to reach out to BCBS and they can’t help, and our BCBS rep has yet to contact me back despite they many messages.
We have billed using the 25 modifier on the E/M, using the CLIA waived modifier and without the CLIA waived modifier yet still being denied.
Thank you in advance for any help with this situation.
And BCN states it needs to be billed with CLIA waived modifier which we have but they are still getting denied. I have tried to reach out to BCBS and they can’t help, and our BCBS rep has yet to contact me back despite they many messages.
We have billed using the 25 modifier on the E/M, using the CLIA waived modifier and without the CLIA waived modifier yet still being denied.
Thank you in advance for any help with this situation.
CPT 81003 inclusvie denieal from Aetna.
Hi all,
Aetna insurance frequently denying CPT 81003 or 81002 charges as inclusive with E&M service (99201-99395).
Initially I tried with modifier 25 to E&M, after that I even tried with an appeal, but no use, it denied as inclusive again.
In this case I need clarification that, is there any payer policy in Aetna website regarding this.
Please help me with your opinions and provide me Aetna policies.
Thanks in Advance for your help.
Thanks & regards.
Srinivasarao.b