Hello,
I am working on a Medical Record Review Dispute and Humana does not agree with our use of 96411. I'm assuming this is because the nurse documented 17 minutes for this. This medication was ordered to be infused over 10 minutes, however due to an overfill with the solution and the rate not being adjusted, it took a few minutes longer. I do not feel comfortable upping the code. Any ideas how to handle this appeal? Its rare to having a payer dispute a charge that I guess technically based on guidelines should be higher.
I am working on a Medical Record Review Dispute and Humana does not agree with our use of 96411. I'm assuming this is because the nurse documented 17 minutes for this. This medication was ordered to be infused over 10 minutes, however due to an overfill with the solution and the rate not being adjusted, it took a few minutes longer. I do not feel comfortable upping the code. Any ideas how to handle this appeal? Its rare to having a payer dispute a charge that I guess technically based on guidelines should be higher.