Wiki Humana Medicare Advantage denial

[pudge2465@yahoo.com]

Is anybody getting Humana Medicare Adv denials stating "THE ENCOUNTER DIAGNOSIS WAS NOT BILLED IN THE PRIMARY POSITION. "

 

[iowagirl77]

Did you review the diagnoses to determine if they were coded correctly? There are several 'encounter for...' diagnoses in the Z codes that are supposed to be the primary diagnosis.

 

[pudge2465@yahoo.com]

Yes. I think I might have found out the problem. I need to place my diagnosis codes better.
Thank you for answering!

 

[klester2018]

Is anybody getting Humana Medicare Adv denials stating "THE ENCOUNTER DIAGNOSIS WAS NOT BILLED IN THE PRIMARY POSITION. "

We have several denials on this however it is only Humana denying, all other Medicare/Advantage Plans are paying.

 

[madden@dmaconsultingllc.com]

I have a question please. I am billing a pre op cardiovascular exam due to the patient having dental work get implants, the Dr also did device check same day during the visit. Humana is denying the claim as THE ENCOUNTER DIAGNOSIS WAS NOT BILLED IN THE PRIMARY POSITION - i billed dx code z01.810 as primary dx for visit then i billed 93284 an 93290 with dx code i50.20 , i42.9 and z95.810. am I missing something or my diagnosis are not on the correct order? thank you for your help .