Tag: #radiology

Posted in #aetna, #Medicare, #Medicareadvantage

Aetna Reimbursement Policy: Radiology Modifiers

Posted on by KR2Medical Billing

According to provider October updates: Aetna will reduce the reimbursement rate for HCPCS radiology codes when modifiers FX and FY are appended.

Modifier FX: the reimbursement rate will be reduced by 20% for the technical component and the (technical component of a global fee) Definition: x-ray images taken by using film

Modifier FY: the reimbursement rate will be reduced by 10% for the technical component and the (technical component of the global fee) Definition: computed radiography X-ray)

Effective for any DOS on or after 1/1/2024.

Type of plans affected: commercial and Medicare lines of business plan types.

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Posted in MVP (NY/VT) Insurance Payer, NY Providers, Payer Updates, Payers and CPT reinbursement, Training

MVP Insurance Payer update: change to Trabecular Bone Scans Reimbursement.

Posted on by KR2Medical Billing

Effective September 1st 2023, MVP will NO longer reimburse separately for Trabecular Bone Scans when done during the Bone density studies.

These scans will he considered incidental to the bone density studies.

CPT codes for Trabecular Bone Studies: 77089,77090,77091, and 77092.

DXA or bone density scan CPT codes that apply to this policy (using central and peripheral dual-enery X-ray are: 77080,77081, and 77085.

This updated reimbursement policy applies to all MVP LOBs- commercial, Managed medicaid and Medicare Advantage Plans.

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