Aetna to begin paying E/M visits with NG tube placements, as well as back denials of E/Ms with drug admins

Why This Topic Matters

It helps readers understand which payer-policy changes may affect older denied claims, what categories of services were involved, and why practices may need to review historical E/M and procedure billing activity.

Article Sections

1. Settlement overview and retroactive claim review

   Summarizes the payer settlement and the general scope of claims affected by the reprocessing and refund review. It also notes the time frames discussed in the article.

2. Affected procedures and claim combinations

   Discusses the types of procedures and service combinations included in the payment review. The section focuses on the broad categories of services involved in the policy change.

3. Temporary modifier handling and system update plans

   Describes interim claims-processing guidance and the planned long-term system changes. It also addresses how the payer expects claims to be handled during the transition period.

4. Broader policy review and strike force provisions

   Covers the settlement language about reviewing other payer payment policies and code lists. It also discusses the general business impact of those policy changes.

5. Additional info

   Provides source references and links for further information related to the policy update and settlement materials.