Wiki Humana and DMEs

[draikaina8503]

Please help. My podiatry practice bills out for DME products such as post-op shoes and pneumatic walkers. Humana has lately been denying them for incorrect modifiers. We have used LT, RT, Medicare modifiers, any modifiers we can find to try to get these paid for. Has anyone else had this problem, and if so how have you been able to fix it? Thanks in advance for any ideas that come through!!!

 

[sune626]

In the past Humana has required a KX modifier be appended to some DME lines- custom orthotics, in my personal experience. Once I added this- the claim was processed correctly. Hope that helps!

 

[draikaina8503]

We've tried that, and the denials do not change. The physician doesn't want us to keep resubmitting claims because he's afraid they're going to start lowering the reimbursement. Any other ideas???

 

[sledson]

I have always billed humana

for example

l3010 kx rt
l3010 kx lt

and gotten paid

if you are still not getting paid - bill pos as pt home