Aetna and Knee Arthroscopies

I live and work in Nebraska. We are having a horrible time with Aetna and CPB 0545. If anyone is familiar with this policy, it is a policy for electrothermal arthroscopy and what will/will not be paid according to Aetna's policy. This is basically applied to shoulders and is rarely performed. I have never seen electrothermal arthroscopy be used on the knee in any setting with this orthopedic group. I have been with them for 11 years now. 

I was wondering if anyone has had successful appealing rates with Aetna or have you been forced to use an ABN with these members in your practice to cover the loss of doing these surgeries?


  • We rarely do them any more, but if we did, I would ask for an ABN and let the patient pay, but do tell them up front that it's not covered.   I have never seen any insurance pay for that procedure, so it's not just Aetna
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