Tag: Evaluation and Management (E/M)
Reload document 
Open in new tab Aetna OfficeLink Updates Published 12/1/2020
For new and updated information on:
- Changes to Aetna’s National Precertification List (NPL)
- Surgical procedures performed in the ER, modifier 54, rate change
- Beginning March 1, 2021 you may see new claim edits. These will be part of Aetna’s 3rd Party Claim and Code Review Program.
- Individual Service Codes are being assigned to Service Groups (a lot of changes are coming)
- Changes in Commercial and Medicare Drug list
- Changes in Prior Authorization Requirements
TMA’s Reimbursement Specialist Want You to Know
About These Items That Are Listed in the UnitedHealthCare December Bulletin:
- Starting January 1, UHC will follow the revised 2021 E&M coding and guideline changes for the AMA and CMS.
- January 1, for Medicare Advantage plans, UHC will expand prior authorization requirements and site-of-service medical necessity reviews.
- And, UHC has delayed implementation of its Laboratory Test Registry protocol
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