Look out for new Aetna denials of nuke codes in a facility

Article Overview

This article discusses a payer policy update from Aetna that affects cardiology and radiology groups billing nuclear imaging services in hospital-based settings. It is aimed at medical coders and billing staff who handle cardiology claims and want to understand why certain professional component claims may be denied in facilities, what general facility-designation issues may be involved, and which organization representatives were involved in clarifying the policy. The article also touches on a prior coverage change involving nuclear imaging add-on services and includes references to the code sets and specific nuclear imaging codes involved.