Wiki Humana Denial 76942 w/injection

[kristincoder]

I am getting a denial from Humana for 76942 with injection code 20610. I understand that sometimes insurance companies will not pay this code due to medical necessity. My question is how do I specifically prove medical necessity? I am trying to educate my providers on what documentation is necessary to back-up using the code.

If anyone has advise or websites I can reference I would really appreciate it!!!

 

[bwilliams1]

I am not sure Humana will pay... check their website.. This is something we found:

76942 Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation Not Covered if used to report ultrasound guidance for needle placement for epidural steroid injections, facet injections, sacroiliac joint injections or trigger point injections

Betsy