Aetna says to resubmit modifier -25 claims starting February 11

Why This Topic Matters

Payer-specific policy changes can affect whether claims are denied, resubmitted, or paid retroactively. Understanding the timing and scope of the update helps practices avoid missed reimbursement and manage claim rework correctly.

Article Sections

1. Policy update and timing

   Introduces the Aetna policy change, including the revised start date and the overall timeframe covered by the update. It also notes the retroactive lookback period discussed in the article.

2. Claims handling and filing requirements

   Summarizes how affected claims are expected to be processed, including electronic filing, resubmission, and timely filing considerations. It also describes the general operational impact on providers and claims staff.

3. Code combinations affected by the policy

   Outlines the broad groups of evaluation and management services addressed by the article and presents the payer-specific combinations referenced. The section focuses on the scope of the policy rather than detailed coding rationale.