Forum - Questions & Answers

Oct 22nd, 2013 - MeganLyman13


Humana has always paid for codes 99212-25 and 97140-59. I just received a bulk EOB from Humana and it is denying 99212-25 saying "use of the modifier is not supported by the information on the claim or in member history" Any knowledge on this would greatly appreciated.

Oct 22nd, 2013 - AWASKEY 17 

re: 99212-25

Have had the same issue from time to time. Do an appeal on each one and include notes so they can see the notes do support the charges. If your notes support a separate charge then you will be paid and the issue will self resolve. If you do not do an appeal you are just confirming the notes do not support a separate charge and you can look for more of the same. Defense of the charges is just as important as billing them correctly. Yes it is a PITA!

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