Billing 99213, 11721 & 11055 Humana

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I am having a hard time getting the any office visit code (99212, 99213, 99214) 11721 & 11055 all paid by Humana. I have always had trouble with this insurance bundling these services and only paying for the lower dollar amount item (this example 11055 was the only one paid). This is how I billed the original claim to Humana:


99213 25 Modifier M20.5X2, M21.6X9, E11.40, M20.41
11721 59, Q9 Modifiers E11.40, I73.9, M79.675, M79.674
11055 LT, 59 Modifiers L85.1, M79.675, E11.40

What am I doing wrong? 2018 I only had a few problems with Humana bundling the codes, this year its all up in the air. Please help me so I can get my provider paid. Thank you in advance! :)
 

aceubanks

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The only way I have found to deal with their denials is to appeal. As long as your office notes substantiate the services, they should overturn their denial and make payment. At least that has been my experience - for me they always deny nails when 97597 and 11721 (59 modifier) are billed together. I appeal and send notes that show they were not inclusive and they make payment. (however, don't send notes with your claim trying to speed it up and avoid the appeal, as they never look at the and then you have to call them and ask them to look at them).
 
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