September 2018
Dear Provider,

Aetna Better Health of Ohio recently identified an issue where our claims encounter data was rejecting due to invalid diagnosis codes. This was the result of a file being incorrectly loaded to our claims payment system for claims received between 10/1/17 through 8/2/18.   There was an "incomplete" field on the source file that was not taken into account when we did the load. Aetna has since fixed the issue and put a process in place to prevent this load error in the future. You are receiving this letter because claims you submitted were affected by the file error.  Claims submitted with these invalid diagnosis codes were paid in error.

As a result, we are reprocessing claims affected during that time period. The Diagnosis Codes affected are:
 

Invalid Diagnosis Codes
A04.7
E88.0
F42
H54.42
K03
M25.52
O64.9
Z01.4
B02
F02.8
F43.1
H66.9
K56.5
M25.61
O99.21
Z79.8
B19.2
F03
F50.8
I21.A
K56.60
M32
R06.8
Z79.81
D50
F03.9
F51
I27
K56.69
M35
R10.8
Z79.89
D86
F10.1
F84
I27.2
K59
M47.81
R26
Z86.01
E10
F10.2
G40.90
I48.9
K59.0
M48
R41.8
Z87.82
E10.3
F11
G47.2
I50
K71.1
M48.0
R47.0
Z87.89
E11
F11.2
G70
I50.3
K80.8
M48.06
R65.2
Z89
E11.0
F12.1
G82.5
I63
L03.9
M54
R68
Z89.51
E11.2
F13.93
H10.50
I69.31
L89.51
M54.0
R97.2
Z98.89
E11.3
F14.1
H11.21
I69.9
L93
M62
S20
E11.329
F17.20
H35.03
I69.91
L97.92
M65.87
S24.159
E11.359
F20.8
H40
I83.0
M06.04
M70
S35.1
E11.4
F25
H40.123
J44
M12.0
M80.0
S42.272
E11.5
F31.1
H50.13
J45
M14.85
M83
S71.102
E13.62
F31.3
H54.0
J45.2
M19
M86.17
T07
E44
F32.8
H54.0X
J45.90
M19.2
M88.81
T14.8
E74.0
F33
H54.11
J84
M19.9
N18
T14.90
E76.2
F34.8
H54.12
J96.0
M25.5
N63
T80.21
E78.0
F40.0
H54.2
J96.2
M25.51
N85
T88.8
Next Step
You will be allowed to rebill for these claims if you would like.   Please contact your Provider Relations Liaison to let us know if you are resubmitting any claims that are past your timely re-filing limit. If you do not know your Provider Relations Liaison, please contact Provider Services at 1-855-364-0974.
Sincerely,
 
 
Aetna Better Health of Ohio
Provider Services



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