12/07/2023

Aetna-Correct Billing for L3000

Hello, I have been seeing patients with the Aetna Medicare Complete HMO as well as Aetna Medicare complete PPO plans. We use ICD10 i73.89. DO you know which of these plans covers L3000? And generally which ICD10s are known to be accepted?

Aetna Medicare Advantage plans have a large number of variations for coverage as do many other carriers. It is recommended to verify benefits as well as confirm conditions that justify medical necessity so a determination can be made to bill the insurance or the patient.  I cannot state a specific ICD as a standalone code that you would use, as each patient has different conditions and reasons to justify the medical necessity and that is the determining factor.