Wiki denials on ua code 81003

[cynthiaarellano14@yahoo.com]

we have been getting a lot of denials from Aetna when billing the urinalysis code 81003 w/ an op office visit, the reason given is incidental to primary procedure, we are an op specialty clinic and I,m not sure what this means?, has anyone else been having this problem and if so how was it handled?, thanks in advance for any help I can get. CAA

 

[allysadean0910]

81003

I have found that if you add mod-25 to the E&M Aetna will cover 81003.

https://www.aapc.com/memberarea/forums/showthread.php?t=55412

 

[tdwallace_79]

we have been getting a lot of denials from Aetna when billing the urinalysis code 81003 w/ an op office visit, the reason given is incidental to primary procedure, we are an op specialty clinic and I,m not sure what this means?, has anyone else been having this problem and if so how was it handled?, thanks in advance for any help I can get. CAA

With Aetna if 81003 is billed with a E/M you need to add mod -25-.

 

[skthandal@gmail.com]

81003

I think you try modifier 25.

 

[balamuruganm]

HI

Modifier 25 with EM followed by 81003