Robin Posted Fri 14th of August, 2015 14:46:54 PM
Getting some denials from Aetna Medicare when we bill 20611 for OA of hip. Turns out they are referring to an LCD which shows ICD9 codes related to the procedure for all areas except hip. shoulder, lower leg, but not the hip.
Is anyone else having trouble with this? Is it because it is done under ultrasound? Any trouble when doing 20610 with fluro?
Help they don't seem to get it when we ask them why?
SuperCoder Answered Mon 17th of August, 2015 05:34:06 AM
As per Aetna: Ultrasound guidance for viscosupplement injections is considered experimental and investigational because it has not been established that this approach will improve health outcomes. You can bill 20610.
Please find below the link for better understanding.