Billed for WWE PAP interpretation

I have AETNA thru the Marketplace. As part of my annual WWE with an in-network provider, I had a PAP smear done. AETNA covered in-full (with no cost-sharing) the visit itself & the PAP collection. However, they denied the claim for the interpretation of the PAP by the in-network lab. (The results were normal.) The EOB states that because the "maximum benefits have been reached for this service for the plan year," the amount billed "is not payable by plan."

For reference, this was my only PAP this year, & my last PAP (which was normal) was done in 2019. I have met my deductible & my out-of-pocket maximum for the year.

I called AETNA. The rep confirmed that it was not coded as diagnostic (I don't have that code, but the CPT was 88141). She did not have any further explanation for the denial (she merely repeated the bit about maximum benefit amounts), & she could not point me to where my plan lists maximum benefit amounts for preventive visits/tests.

Has anyone else encountered this? I thought that preventive PAPs were covered in-full by plans governed by the ACA.

Thanks in advance!

submitted by /u/Emergency_Bet_1144
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