This policy applies to Aetna Medicaid members and for the portable x-ray services done on 08/01/2021 and thereafter.
Aetna Better Health of Louisiana (ABHLA) is aligned with the Louisiana Department of Health’s Medicaid Services Manual, and would like to remind providers to refer to these manuals when submitting claims.
Reimbursement:
ABHLA will reimburse payment of medically necessary diagnostic x-ray services to Medicaid eligible recipients who are unable to travel to a physician’s office or outpatient hospital’s radiology facility.
Specific diagnostic radiology services for an eligible recipient may be provided in the recipient’s place of residence by an enrolled portable x-ray provider. These services are only considered for payment when they are medically necessary and ordered by the recipient’s physician.
The Portable X-Ray reimbursement policy includes the following:
• Transportation of portable x-ray equipment is reimbursable only when the equipment used is actually transported to the location where x-ray services are provided.
• A single transportation payment per trip to a facility or location for a single date of service is reimbursed.
Medical Coding and Billing Corner:
Proper documentation needed: Physician’s order for portable x-ray services must include the suspected diagnosis or reason the x-ray is required, area of the body to be exposed, number of radiographs ordered, and the precise views needed.
Proper Place of Service: Portable x-ray units transported to a recipient’s residence are to be billed with the Place of Service (POS) as the location where the service has been rendered, rather than using POS 15 (Mobile Unit). The recipient’s place of residence should be billed with the appropriate POS on the CMS-1500
Need more information, please contact Aetna Louisiana Better Health: via email- LAProvider@AETNA.com or call 1-855-242-0802 and follow the prompts.
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