Aetna: Get ready for MAC denials on pain procedures

Why This Topic Matters

Payer policy changes can alter how anesthesia services are reimbursed for pain management encounters. This article helps readers understand the scope and timing of the Aetna update and identify the affected procedure families.

Article Sections

1. Policy update and physician reaction

   Introduces the payer change, the general context for monitored anesthesia care claims, and stakeholder response from specialty organizations and physicians.

2. Fluoroscopic guidance reimbursement update

   Summarizes the related discussion of fluoroscopic guidance payment timing and retroactive claim treatment.

3. Development of the monitored anesthesia care policy

   Describes the background of the payer review process and the specialty society discussions that shaped the final approach.

4. Pain codes non-reimbursable by Aetna for MAC

   Presents the list of pain procedure codes referenced in the payer notice and the effective date for the change.