MAG Instrumental in Settling Dispute Over “Add-On Codes”
MAG and several other state medical societies have reached an agreement with Aetna in regards to the resubmission of claims, after their failure to pay for certain add-on codes as required by the lawsuit settlement in May 2003.
Aetna’s settlement mandated that add-on codes would be recognized and eligible for payment as separate codes and would not be subject to Multiple Procedure Logic. The unrecognized add-on codes for CAD mammography and myocardial profusion will now be paid by Aetna, following the compliance dispute.
Beginning April 17, physicians will be permitted by Aetna to resubmit claims and to submit new claims for these codes for specific time periods. The agreement reached by MAG and Aetna is especially pertinent to cardiologists and radiologists. Timely filing and appeal deadlines will be waived. The claims must be submitted no later than July 14, 2006.
All updates on the agreement with Aetna will be posted on www.mag.org, including the claim form, once finalized. For more information, please contact the Office of the General Counsel at 678.303.9281.