Wiki Radiation Oncology 77427

[agnes.andrews@emoryhealthcare.org]

I am working a denial with 77427 per the Humana policy (Humana plans require providers to submit each charge for CPT code 77427 with a “from” date representing the date of the first session of the charge and a “to” date representing the date of the last session of the charge.) what supporting documentation can be set to overturn the denial. I am new to this specialty,

Thank you advance for your help

 

[sls314]

I am working a denial with 77427 per the Humana policy (Humana plans require providers to submit each charge for CPT code 77427 with a “from” date representing the date of the first session of the charge and a “to” date representing the date of the last session of the charge.) what supporting documentation can be set to overturn the denial. I am new to this specialty,

Thank you advance for your help

You need to send a corrected claim billed the way Humana wants it.

Humana had a revision in June 2022 to its Radiation Therapy Treatment Management billing and coding policy. You can find the policy at this link to make sure that your corrected claim is set up the way Humana wants it: https://www.humana.com/provider/medical-resources/claims-payments/claims-payment-policies

(The link goes to all of Humana's Claims Payment Policies - search for the Radiation Treatment Management one. If you scroll down it's about half way down the list.)

There was another thread discussing it here recently (after Humana's policy changed & we were all caught off guard for a bit) You might be able to pick up some helpful hints if you look at that too: https://www.aapc.com/discuss/threads/humana-denying-77427-as-bundled.189921/

Also if you're interested, you're welcome to join the Facebook group for Radiation Oncology Billers and Coders: https://www.facebook.com/groups/radiationoncologycoders

 

[agnes.andrews@emoryhealthcare.org]

You need to send a corrected claim billed the way Humana wants it.

Humana had a revision in June 2022 to its Radiation Therapy Treatment Management billing and coding policy. You can find the policy at this link to make sure that your corrected claim is set up the way Humana wants it: https://www.humana.com/provider/medical-resources/claims-payments/claims-payment-policies

(The link goes to all of Humana's Claims Payment Policies - search for the Radiation Treatment Management one. If you scroll down it's about half way down the list.)

There was another thread discussing it here recently (after Humana's policy changed & we were all caught off guard for a bit) You might be able to pick up some helpful hints if you look at that too: https://www.aapc.com/discuss/threads/humana-denying-77427-as-bundled.189921/

Also if you're interested, you're welcome to join the Facebook group for Radiation Oncology Billers and Coders: https://www.facebook.com/groups/radiationoncologycoders

Thank you so much i appreciate the response and resources