• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
  • Important Note: We will be performing a scheduled maintenance on 1st November 2020. The site will be offline from 7:30PM (MT) till midnight. We apologize for any inconvenience this may cause.

Humana requiring anatomical modifier

Messages
1
Location
Conroe, TX
Best answers
0
I have received a denial from Humana Medicare requiring an anatomical modifier on CPT 63020, Excision of a cervical disk, one level. Has anyone else seen this or similar? I believe their edit is incorrect/invalid, but am looking to see how prevalent the denial is, to determine how far to fight it.

Thank you!

Shana DuBois, CPC
 

mk2001

Networker
Messages
75
Best answers
0
We have to attach LT, RT or 50 modifier on all of our procedures that have a bilateral surgery indicator of 1 when billing Humana. I don't know anything about 63020 but it has an indicator of 1. Maybe they're asking for which side the lamina was removed. Again, not my area, I looked up the description of the code and just taking a guess.
 

jbland

Contributor
Messages
17
Location
Brooklet, GA
Best answers
0
Have you called them? I have seen Humana many times say one thing on the denial and call them and it was denied for another completely different reason. I have not looked at the code, but I have had a few things deny for something completely different when I called them. Yes, I know, I do not have time to call all of these insurance companies. Maybe they need documentation?
 
Top