# Humana Denial



## astumler98 (Jan 21, 2016)

Is anyone having trouble with Humana not paying office visits, even with a mod 25 attached? These are all being denied in our office and bundled with lab services or vaccines. Does anyone have any thoughts are how to correct?


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## Cynthia Hughes (Jan 21, 2016)

Are you appending modifier 25 to E/M codes reported on the same date as vaccine administration codes (90460-90461, 90471-90474)? There are CCI bundling edits for vaccine administration codes with problem-oriented and preventive E/M services. Not sure about denial of E/M with labs. Hope that helps.


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## astumler98 (Jan 21, 2016)

We do at the 25 to WCC codes, 99391-99395, then the vaccine code and the admin code.


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## jh1991 (Jan 26, 2016)

*jh1991*

Not just OVs but other codes. I have one claim seeing a hospice patient for non hospice treatment (Humana Medicare Advantage). Filed with Medicare 1st then with Humana for co-insurance.  Medicare said Humana should pay but they keep refusing, telling me to file with Medicare. Have sent all information and a letter.  Same reply.


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