Wiki Humana Denials 71271

[KELLEYB]

Is anyone having an issue with Humana paying 71271 with ICD-10 Z87.891? We are billing professional only with a 26 modifier. We have been paid up until December and now claims are denying for DX code.

 

[sls314]

Is anyone having an issue with Humana paying 71271 with ICD-10 Z87.891? We are billing professional only with a 26 modifier. We have been paid up until December and now claims are denying for DX code.

Is this for commercial or Medicare? I only ask because I was looking up the Medicare coverage info to see if there were any recent changes, and it occurred to me that you might be talking about a commercial plan instead.

(We don't really have any commercial Humana in my area - it's pretty much all Medicare, so my instinct for Humana is always to jump right to looking up Medicare policies/LCD/NCD.)

 

[KELLEYB]

Is this for commercial or Medicare? I only ask because I was looking up the Medicare coverage info to see if there were any recent changes, and it occurred to me that you might be talking about a commercial plan instead.

(We don't really have any commercial Humana in my area - it's pretty much all Medicare, so my instinct for Humana is always to jump right to looking up Medicare policies/LCD/NCD.)

This is for Medicare products.

 

[Jill Lanich]

We encountered the same issue. I tried resubmitting a claim with Z12.2 as the first listed DX and received payment. Not sure why they changed their policy as I couldn't find anything about this on their website.

 

[jalabergeron]

There is an age restriction with Medicare: According to CMS, "71271 to be billed only if the beneficiary is between the ages of 50 and 77 for claims with date of service on or after February 10, 2022."
If the beneficiary is older than 77, how is this supposed to be billed out?