Wiki Humana 64636

[GMMTimmons]

Having a little debate on how Humana is wanting us to bill add on codes.
Example we billed
64635-50 1 unit
64636-50 2 units
and was denied per AAPC coding guidelines. Are they wanting ?
64635-50 1 unit
64636 1 unit
64636 1 unit

 

[Orthocoderpgu]

In your example billed code 64636 has a total of 4 units being billed.
In your example of what they may want 64636 only has two total units being billed.
You need to make sure that the units you are billing are accurate to what was actually done.

 

[GMMTimmons]

In your example billed code 64636 has a total of 4 units being billed.
In your example of what they may want 64636 only has two total units being billed.
You need to make sure that the units you are billing are accurate to what was actually done.

The 4 is the correct units for the 64636 ( 2 bilaterals). but now they want the add on bilaterals split into 2 lines..
So does Humana now want:
64635-50 x 1
64636 x 1
64636 x1
64636 x1
64636 x1

Or
64635 -50 x 1
64636 LT x 2
64636 RT x 2