Wiki Humana Overpayment Request

[DermBillers]

Is anyone else experiencing where Humana is requesting a refund stating that the modifier is not supported by claim information. We billed an office visit (99213) with the modifier 25 as there was a procedure done that day (17110) in this case. The modifier is appropriate but they have offset my claim. They have not seen the records as of yet but I will attempt to appeal as I know the modifier is appropriate. Thanks for any feedback.

 

[Orthocoderpgu]

Go to the NCCI surgical policy manual, chapter one, general coding guidelines, and read the last paragraph of page I-12.