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Aetna Add On Code Claims Payment

Please Note: The July 14, 2006 deadline for resubmission or new claims from physicians related to the “add on codes” outlined below has passed.

Resubmission or new claims from physicians related to the codes referenced below submitted after July 14, 2006 will not be considered for payment. Therefore, effective July 15, 2006, any physician claims submitted for the below referenced add on codes will not be considered by Aetna for payment.

Background
In April, 2006, Aetna and representatives of various state medical societies reached agreement settling a dispute about the payment of claims for certain “add on codes.”

During the period of April 17, 2006 through July 14, 2006, Aetna considered the resubmission or new claims from physicians related to:

  • CAD Mammography Services (CPT Codes 76082 and 76083) provided to Aetna members between January 1, 2004 and March 31, 2005; and/or
  • Myocardial Perfusion Testing Services (CPT Codes 78478 and 78480) provided to Aetna members between January 1, 2004 and May 12, 2005

New or resubmitted add on code claims had to have been submitted between April 17, 2006 and July 14, 2006 to be considered for payment.

Questions and Assistance: For further information about this deadline or the status of add on code claims you may have submitted or resubmitted, please call the Aetna Provider Service Center at:
1-888-632-3862 for indemnity and PPO-based benefits plans, or
1-800-624-0756 for HMO benefits plans