Hi MichaelSL,
There isn't a lot of detail(s) provided with your post. What was the claim adjustment code provided by Humana? Have you ever by chance utilized Modifier 57 (Decision for Surgery)? Like I stated I am unsure what procedure(s) was done or what the E&M provider's note actually states. Hmm ~ dealing with Humana denials in the past... You stated that you googled their website without success. Personally, at this point, I would take the time to call in to Humana or ask your AR person or biller to call into Humana and ask on this denial and discover truly why Humana simply feels that these two codes procedure cannot be billed on the same DOS for reimbursement ~ this may save headaches moving forward dealing with other similar procedures/E&M procedures with Humana to prevent denials. In my prospective if the documentation supports billing both procedsures ~ then please simply appeal it with documentation.
Thanks for listening,
Dana Chock, RHIT, CPC, CANPC, CHONC, CPMA, CPB