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2018 New CPT codes

00731  Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified ...

Aetna Code Edits and Claim Payment Policy

Surgical pathology

As of October 17, 2010, 88346 (immunofluorescent study, each antibody; direct method) is allowed five times per date of service.

Multiple procedure reductions for CT scans, MRIs or ultrasounds

For dates of service on or after February 1, 2011, the policy for multiple procedure reductions for certain diagnostic imaging services will change. The initial CT scan, MRI or ultrasound will be allowed at 100 percent and subsequent scans performed on the same day will be allowed at 50 percent.

The reduction will apply to: scans performed on contiguous body areas, and technical and global charges

Surgical repair of vesticular stenosis

Effective February 1, 2011, 30930 (fracture nasal inferior turbinate(s) therapeutic) will be allowed when billed with 30520 (septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement  with graft). 

Effective March 1, 2011, 30930 (fracture nasal inferior turbinate(s) therapeutic) will be allowed once per date of service.

Impression casting of a foot when billed with an orthotic procedure

Effective March 1, 2011 HCPCS code S0395 will be denied when billed with an orthotic procedure code (L0100 - L9999) within a 90-day timeframe.

Prosthetic socks

Effective February 1, 2011, L8400 - L8499 will be allowed twelve (12) times per prosthesis per date of service.

Reference: http://www.aetna.com/provider/data/OLU_SE_DEC2010_v4.pdf

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