As of Aug, 12, Aetna began paying
claims for electrocardiograms
(CPT code 93010) when billed with evaluation and management
(E&M) services (CPT codes 99281-99285), even without a modifier
Previously denied physicians' claims
for the prior six months of Feb. 10 to Aug. 12 can be resubmitted
for payment until Nov. 10.
Aetna says it will post instructions for resubmitting claims on
Aetna agreed to begin paying their claims after North Carolina
emergency physicians filed a settlement compliance dispute. They
said Aetna was not living up to the terms of the settlement of its
part of the federal class action antiracketeering lawsuit against
some of the nation's largest for-profit HMOs by TMA and 18 other
state medical societies.
TMA General Counsel Donald P. Wilcox, JD, says physicians should
pay close attention to the terms of the settlements in the lawsuit
and file a compliance dispute if they find that Aetna or any other
company involved in the case are not keeping the promises they made
when they agreed to change their business practices.
More information about the lawsuit, the HMOs involved, and the
compliance process is available at