Wiki Help with Aetna Medicare Well women visit

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mlange85

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Hello~
I was hoping for some advise on billing annual well women to Aetna Medicare. We are currently billing them using G0101,Q0091 with dx codes Z01.419,Z12.4 on each. They keep denying Q0091. Not sure if it the DX codes? I don't feel this is quite right, however, this is how it was always billed before I started. Any help would be greatly appreciated!!!!

Mary
 
I always bill to Medicare with G0101 and Q0091 carved out of the age appropriate preventative code with GA modifiers if patient signed the ABN. I use Z01.419 or Z01.411 on both codes. The only time we get denials is if they have paid in the past 2 years.
 
mlange85 said:
Hello~
I was hoping for some advise on billing annual well women to Aetna Medicare. We are currently billing them using G0101,Q0091 with dx codes Z01.419,Z12.4 on each. They keep denying Q0091. Not sure if it the DX codes? I don't feel this is quite right, however, this is how it was always billed before I started. Any help would be greatly appreciated!!!!

Mary
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Hi Mary,

You cannot code both Z01.419 and Z12.4 on the same claim. There are an excludes 1 note for the codes stating they cannot be billed together on the same claim.

I hope this helps. :D
 
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