On June 15, Aetna announced that it will allow reconsideration (retroactive reimbursement) for claims where it previously bundled add-on codes for wall motion (78478) and ejection fraction (78480) when performed with myocardial perfusion imaging (MPI) studies (78460-78465). Based on a May 14 implementation date, Aetna will allow reconsideration for 180 days from the date of the initial claim determination provided that the claim was submitted within the timely filing limits or 60 days for an appeal if reconsideration has previously occurred and that appeal rights still exist for the claim.

ASNC has been pressing Aetna on this issue for the past two years and is extremely pleased that the carrier has decided to conform to the original terms laid out in the settlement regarding "bundling and other computerized claim editing" - Settlement Provision 7.20 (b). In an effort to recover retroactive reimbursement for claims involving the add-on codes for MPI studies dating back to 2003, ASNC Past-President Robert Hendel, M.D., and Midwest Heart Specialists are currently progressing through the compliance dispute process, which is outlined in the Aetna Settlement. Dr. Hendel also spearheaded ASNC's efforts to force Aetna's compliance with the settlement during his tenure as the Society's President from 2003-2004.