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Click here for more sample CPC practice exam questions and answers with full rationale

Medicare Advantage Plan (Humana)

Humana has been denying our Electrocardiogram, routine ECG with at least 12-leads; interpretation and report only; 93010. Our ER physicians bill this procedure code and Humana has been denying them stating the procedure code is incorrect/or invalid. Of course, I have call Humana and they only say I need to send in the ER notes. Then I found out from coding/editing at Humana that they feel as if the ER physicians abuse this CPT code this is why they want the ER notes. Does anyone know where I can locate the Medicare guidelines for this CPT code? Medicare does pay for this procedure. Or if anyone knows where I can find Humana’s policy about this CPT code it would be greatly appreciated.

Medical Billing and Coding Forum