Ophthalmology and Optometry Coding Alert
Beware This Humana Billing Snafu
Question: We just got a denial from Humana for billing 67028 together on the same claim form with drug code J0178. We have appealed this denial, but we got the response that the “First decision stands.” What can we do to correct the claim? AAPC Forum Participant Answer: Getting denials in the Humana system for coding 67028 (Intravitreal injection of a pharmacologic agent (separate procedure)) with J0178 (Injection, aflibercept, 1 mg) is a known problem. Humana has indicated they are reworking affected claims, but as of the time of publication, they have not resolved the issue and the code combination is still subject to denials, even though there is nothing preventing the codes from being billed together.
Ophthalmology and Optometry Coding Alert
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