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Aetna to change ASC payment process — 3 details

Aetna is changing how it will handle certain ASC and ambulatory payment classification code edits, according to AdvantEdge, a medical billing company.

Three details:

1. CPT/HCPCS codes that generate ASC and/or APC error codes indicating a service isn't covered by Medicare won't be eligible for default payment from Aetna.

2. Aetna's changes to provider compensation will depend on the Medicare ASC and/or APC payment methodology included in the provider contract.

3. The changes apply to code edits under the ASC and APC payment methodologies and will take effect Nov. 1.

Click here for more details.

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