- advertisement -

Aetna update

Discussion in 'Insurance Issues' started by jane1218, Aug 20, 2008.

  1. jane1218

    jane1218 Approved members

    Joined:
    Jul 8, 2008
    Messages:
    96
    I sent in my appeal to Aetna August 5th. They received it August 11th. I faxed supplemental information August 13th, after life threatening hypoglycemia, this included a new letter of medical with an additional dx code that includes hypoglycemia.

    I called August 15, they were very helpful. They made sure the letter and materials I mailed were put together with the letter and new materials I faxed.

    I called back today for a status report. She gave me a case number so it would be easy to check on the status the next time I called. When she looked in the system it said a decision would be made by August 30th. She said sometimes decisions come in earlier and the computer would be updated before I received a letter, so she said to call in about a week.

    I am crossing my fingers.
     
  2. BrendaK

    BrendaK Neonatal Diabetes Registry

    Joined:
    Oct 29, 2005
    Messages:
    3,835
    Was the new diagnosis code 250.83??? I am hearing that's what Aetna wants.

    Ours got denied with them last week, so we are working on an appeal. Abbott is contacting the endo for more info. I did talk to the endo and they won't change the diagnosis code to 250.83. It sounds like it's appropriate for you, though because that code covers hypoglycemic shock and seizures, or something like that.

    GOOD LUCK!!!!
     
  3. Adinsmom

    Adinsmom Approved members

    Joined:
    Sep 12, 2006
    Messages:
    2,995
    What is a diagnosis code?
     
  4. BrendaK

    BrendaK Neonatal Diabetes Registry

    Joined:
    Oct 29, 2005
    Messages:
    3,835

    It is the code that the doctor puts on your chart that says what disease or issues you have. It's used for medical billing purposes and the code is sent to the insurance company.
     
  5. Adinsmom

    Adinsmom Approved members

    Joined:
    Sep 12, 2006
    Messages:
    2,995
    So there are different insurance codes for type 1 diabetes? Like how many? You can pm me if you prefer.
     
  6. BrendaK

    BrendaK Neonatal Diabetes Registry

    Joined:
    Oct 29, 2005
    Messages:
    3,835
    Yes, there are different codes depending on if you have complications or not. They are actually called ICD-9 codes -- you can google type 1 diabetes ICD-9 and there's a lot of info. Basically, from my limited understanding, 250.xx is the code for diabetes. The numbers that goes where the x is says what kind of complications or issues you have along w/ it. 250.03 is diabetes w/no complicaions, 250.13 is DKA, uncontrolled, 250.61 is neuropathy, diabetic, and the list goes on forever with whatever diagnosis you have. There is a whole profession and classes you can take regarding medical coding -- it's kind of a universal language for medical billing purposes. Does that make sense?
     
  7. Adinsmom

    Adinsmom Approved members

    Joined:
    Sep 12, 2006
    Messages:
    2,995
    Thanks. :cwds:
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice