Providers

Making It Easier for Health Care Providers: An educational series

“Making It Easier for Health Care Providers” is a series of educational presentations about Humana’s claims payment policies. Please complete the survey at the end of each presentation to give us feedback and tell us what other topics are important to you. Additional materials will be added periodically.

Topics

Application of Medicare NCD/LCD Guidelines (link opens in new window)  :  Learn how Humana administers Medicare national coverage determinations (NCDs) and local coverage determinations (LCDs) for Medicare Advantage members. This presentation includes a printable tip sheet.
Medicare Preventive Services (link opens in new window)  :  Learn about Humana’s policies for coverage of preventive services for Medicare Advantage members. Topics covered include initial preventive physical examinations (IPPE), annual wellness visits (AWV), annual preventive physical exams and well-woman exams. This presentation includes a printable tip sheet.
Professional Component and Technical Component (PC/TC) (link opens in new window)  :  Learn about proper reporting and reimbursement policies for the professional and technical components of a service. This presentation includes a printable tip sheet.
Humana’s Maximum Unit Values (link opens in new window)  :  Learn about Humana’s approach to maximum unit values for commercial, Medicare Advantage and Medicaid members. This presentation includes a printable tip sheet.
Chronic Care Management Services (link opens in new window)  :  Learn about Humana’s policy for coverage of the chronic care management services code when submitting claims for Medicare Advantage and select Medicaid members. This presentation includes a printable tip sheet.
Drug Testing and Codes (link opens in new window)  :  Learn about Humana’s policies on drug testing for commercial, Medicare Advantage and select Medicaid members. This presentation includes a printable tip sheet.
Humana’s Approach to Code Editing (link opens in new window)  :  Learn about Humana’s approach to code editing for commercial, Medicare Advantage and Medicaid members. This presentation includes a printable overview.
Modifier 24 (link opens in new window)  :  Learn about Humana’s policy requiring the use of modifier 24 when submitting claims for Medicare Advantage, commercial and select Medicaid members. This presentation includes a printable tip sheet.
Procedure-to-Procedure Code Editing (link opens in new window)  :  Learn about Humana’s procedure-to-procedure code editing when submitting claims for commercial, Medicare Advantage and Medicaid members. This presentation includes a printable tip sheet.
Modifiers 59 & X{EPSU} (link opens in new window)  :  Learn about Humana’s policy on the use of Modifiers 59 & X{EPSU} when submitting claims for commercial, Medicare Advantage and select Medicaid members. This presentation includes a printable tip sheet.
Anatomical Modifiers (link opens in new window)  :  Learn about Humana’s policy requiring the use of anatomical modifiers when submitting claims for commercial and Medicare Advantage members. This presentation includes a printable tip sheet.
Modifier 25 (link opens in new window)  :  Learn about Humana’s policy on the use of modifier 25 when submitting claims for commercial, Medicare Advantage and select Medicaid members. This presentation includes a printable tip sheet.
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