Billing for routine eye exams on AETNA patients
- By Blog Owner
- •
- 27 Mar, 2017
- •
When performing routine eye exams on Aetna Patients it is a good idea to get in the habit of using
Z01.00 OR Z01.01 as your diagnosis code INSTEAD of a code beginning with "H52". This is because many of Aetna's plans actually are set up to pay for routine eye exams but ONLY if the primary diagnosis is = Z01.00 OR Z01.01. Even though this does NOT affect EVERY Aetna plan that provides patients with a routine eye exam, using these codes will NOT cause a denial...EVER (as long as the patient has coverage for routine services) whereas using a code that begins with "H52" does, in fact, cause denials in many cases (even when the patient DOES have coverage for routine services).
As always, I hope you find this information both useful and informative.
Z01.00 OR Z01.01 as your diagnosis code INSTEAD of a code beginning with "H52". This is because many of Aetna's plans actually are set up to pay for routine eye exams but ONLY if the primary diagnosis is = Z01.00 OR Z01.01. Even though this does NOT affect EVERY Aetna plan that provides patients with a routine eye exam, using these codes will NOT cause a denial...EVER (as long as the patient has coverage for routine services) whereas using a code that begins with "H52" does, in fact, cause denials in many cases (even when the patient DOES have coverage for routine services).
As always, I hope you find this information both useful and informative.
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