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Billing 99213, 11721 & 11055 Humana

I am having a hard time getting the any office visit code (99212, 99213, 99214) 11721 & 11055 all paid by Humana. I have always had trouble with this insurance bundling these services and only paying for the lower dollar amount item (this example 11055 was the only one paid). This is how I billed the original claim to Humana:

99213 25 Modifier M20.5X2, M21.6X9, E11.40, M20.41
11721 59, Q9 Modifiers E11.40, I73.9, M79.675, M79.674
11055 LT, 59 Modifiers L85.1, M79.675, E11.40

What am I doing wrong? 2018 I only had a few problems with Humana bundling the codes, this year its all up in the air. Please help me so I can get my provider paid. Thank you in advance! :)

Medical Billing and Coding Forum

11721

I work for an FQHC in California

we keep getting denials from one of our payers; when our billers bill 11721 with 1105, 11056 or 11057. Claims state that 11721 is not separately payable, that a modifier is needed and that 11055-11057 are exclusive when billed with 11721. I am so confused. which one is it? I thought 11721 didn’t need a modifier only for Medicare. Any one know have any information?

thank you

Medical Billing and Coding Forum

11720 and 11721

My understanding is that code 11720 is for 5 or less and 11721 is for 6 or more. Based on this info I feel if my docs does 7 toes I bill 11721 once. He is telling me I need to bill it 11721 x7 since he did 7 toes. Same for 11720 if he does 3 toes. Can someone clarify correct billing for this code (i.e. 11721 is inclusive whether doing 6 toes or 9 or you bill out each toe).

Medical Billing and Coding Forum