G0180 Denied

Hello,

We have a provider billing G0180 to Aetna as primary and Medicare as secondary.
Aetna denied this service stating this code should only be billed to Medicare.

Is this correct?

Thank you.

G0180

That is correct.
See codes 99374-99380 for non-medicare.

G0180--Care Plan Oversight

Two articles on Care Plan Oversight, one relating to Medicare, and one to commercials.

I think your situation is complicated because Medicare is secondary: if the commercial doesn't pay on the 99374--99380 series of codes, it will be hard, because Medicare doesn't recognized those codes.

http://www.codapedia.com/~article_182_.cfm

http://www.codapedia.com/~article_162_.cfm

G0180

Thank you.