For any od's out there that bill Aetna, BE CAREFUL WHEN SENDING CLAIMS!
DO NOT INCLUDE ANY REFRACTIVE DX CODES ON THE CLAIM....AETNA WILL ERRONEOUSLY DENY AS ROUTINE, EVEN IF THE REFRACTIVE CODE IS NOT PRIMARY.
I had to call Aetna and fight them today because they denied a medical claim (primary dx was 375.15 dry eyes) because the secodary DX was 367.1, myopia. They told me this exam was routine. I told them....NO IT IS NOT! I HAD TO CORRECT THE "CLAIM SPECIALIST"!!!
THE MORAL OF THE STORY: AETNA DOESN'T LIKE TO PAY CLAIMS...PERIOD!
For more optometric billing information go to: www.opticXpress.com and see what they can offer you. They will even fight Aetna for you on issues such as this!
opticXpress is an optometric billing company that provides a clearinghouse, billing service and software strictly for optometrists.
