Wiki Humana -78 modifier denial for same day return to surgery

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ABorchardt

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Is anyone having trouble with Humana denying -78 return to or same day for anesthesia services? Its a commercial plan. We have 2 separate claims, on 2 separate people, in different months, not being paid. We have sent in medical records to show separate times for same date. Humana review upheld their denial AFTER getting all of the information. We currently sent it in again for escalation to Humana. I would appreciate some suggestions on this.
 
ABorchardt said:
Is anyone having trouble with Humana denying -78 return to or same day for anesthesia services? Its a commercial plan. We have 2 separate claims, on 2 separate people, in different months, not being paid. We have sent in medical records to show separate times for same date. Humana review upheld their denial AFTER getting all of the information. We currently sent it in again for escalation to Humana. I would appreciate some suggestions on this.
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I'm not sure if it works the same with anesthesia but we add the XE modifier to our same day surgeries to show they were same day but separate encounters.
 
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