You'll also find information about a wide variety of topics, ranging from provider responsibilities, to how to file a claim, to grievance and appeals processes. 24/7 assistance via toll-phone, fax or email. Aetna (Commercial and Medicare Advantage Plans - effective 09/01/2016)* Clinical payment and coding policies are based on criteria developed by specialized professional societies, national guidelines (e.g. Accepting New Patients. including surgeon's and assistant surgeon's fees. WFUHS - Wake Forest University Health Sciences (professional services) NCBH - North Carolina Baptist Hospital. Precertification You need pre-approval from us for some eligible health services. Chesapeake, VA 23320 . Home | Aetna Better Health of Pennsylvania • If you are already using a vendor, add Aetna to your list of payers. Assistant Surgeon/Assistant at Surgery . Audiology Services . . UNC Health Provider. Professional, Multiple and Bilateral Surgery Services Performed During the Same Operative Session . Check Medicare Physician Fee Schedule (MPFS) Indicator/Descriptor Lists. Access to Aetna's team of clinicians. Breast Surgery . You can save money by seeing In-network Providers because Aetna has negotiated special rates with them, and because the Plan's benefits are better. If you don't see your plan or you have questions, please call our Customer Service Center at 877-938-7497. 2020/11/18. Box 14089 Lexington, KY 40512-4089. For individuals and families. Modifier 80 is appended to the surgical code when another surgeon is assisting at surgery. PDF CMS Manual System For Health Care Providers | Aetna Medicaid New Jersey PDF Volume 10, Issue 1 Aetna OfficeLink Updates 57 . 2020/06/25. See Column A indicates if assistant at surgery allowed/not allowed. Gastrointestinal Surgery, Cancer. Surgical procedures eligible for assistant surgeon performed by RNFAs must be billed using the primary surgeon's provider number, including . Website: www.aetna.com Aetna, a CVS Health Company salaries: How much does Aetna ... Non-physician providers assisting with surgery should append modifier AS. Average Aetna, a CVS Health Company hourly pay ranges from approximately $11.98 per hour for Customer Service/Data Entry to $36.84 per hour for Quality Assurance Analyst. Assistant at Surgery Modifiers Require Specific Documentation. Jacob Wood, MD | Vascular Surgery | UNC Health 100% of eligible charges subject to plan copayments. Below is a high-level summary of some of the changes, including updated code auditing rules related to existing codes, as well as the January 1, 2020 code release of CPT® and HCPCS. Eligibility Criteria . Assistant Professor. Medical Assistance covers all medically necessary dental services for enrolled children. PDF CMS Manual System Jonathan Stem, MD | Gastrointestinal Surgery | UNC Health Aetna Customer Service Phone (Aetna One Advisor): 800-843-9126. Assistant at Surgery Modifiers Fact Sheet codes may be processed and to determine eligibility of an assistant surgery procedure - Policy Information — to find policy-related links if Unless otherwise stated, Oxford policies do not apply to Medicare Advantage enrollees. Physician: Assist-at-surgery allowed with appended modifiers 80, 81 . Maternity Claims Adjusted Procedures. ©2020 Aetna Inc. Office Manual for Health Care Professionals (applies to all regions) Link to PDF. UNC Health providers are employed by an organization within UNC Health. multiple procedure guidelines, as well as being eligible for assistant surgeon services, benefits for those services will be allowed and processed according to the multiple procedure guidelines. Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). 2020/06/12. After deductible NJ DIRECT1525 and 2030 pay 70% of eligible charges not covered by Medi- Assistant Surgeon Modifiers Modifier 80, 81, 82: Denote assistant surgeons. The AlaskaCare Retiree health plan was created by statute to provide health coverage to eligible retirees and their dependents in 1975. The "assistant at surgery" provides more than just ancillary services. We will do our best to work with you and your plan. For individuals and families. Reimbursement for Assistant-at-Surgery services, when reported by the Same Individual Physician or Other Qualified Health Care Professional, is based on whether the Assistant-at-Surgery is a Physician (designated by modifiers 80, 81 Pre-trip guidance to help with your next move. As an Aetna ® provider, there are certain procedures and protocols you need to know. Over my almost 30-year surgical coding career, the documentation for assistant surgeons consisted of only the name of the assistant surgeon in the operative note header. Should be submitted on those surgical procedures where an assistant surgeon is warranted. You'll find most of the information you need in the provider manual.You'll learn which services our plan covers. Information is current as of: 11/6/2020 3:13:00 PM For latest information, call: 1. Access to Aetna's team of clinicians. Hand Surgery - Eligible Orthopaedic Surgery - American Board of Orthopaedic Surgery, 2018 . Reimbursement Policies. R 12/20.4.3/Assistant-at-Surgery Services R 12/110/Physician Assistant (PA) Services Payment Methodology N 12/110.1/Global Surgical Payments R 12/110.2/Limitations for Assistant-at-Surgery Services Furnished by Physician Assistants R 12/110.3/Outpatient Mental Health Treatment Limitation R 12/110.4/PA Billing to the Contractor . 1.8 07/17/2020 Vicky Hicks Mary Larson Updated Provider Representative List extensions. Decision for Surgery An evaluation and management service that resulted in the initial decision to perform the surgery may be identified by adding modifier 57 to the appropriate level of E/M service. Our health plan is a subsidiary of Aetna, which has more than 150 years of experience in . 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