Making it easier

An educational series for providers and healthcare professionals
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“Making It Easier for Physicians and Other Healthcare Providers” is a series of educational presentations about Humana’s claims payment policies and processes. Additional materials will be added periodically.

Educational presentations

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Use of Non-Specific Procedure Codes

Updated: July 2019. Learn about Humana’s requirements for submission of non-specific, or unlisted, CPT or HCPCS codes for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This presentation includes a printable tip sheet. Runtime: 14:31.

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Anatomical Modifiers

Updated: July 2019. Learn about Humana’s policy requiring the use of anatomical modifiers when submitting claims for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This presentation includes a printable tip sheet. Runtime: 14:47

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Procedure-to-Procedure Code Editing

Updated: June 2019. Learn about Humana’s code editing for incidental, mutually exclusive and unbundled code combinations. This information applies to claims for your patients with Humana Medicare Advantage, commercial or select Medicaid plans. This presentation includes a printable tip sheet. Runtime: 13:51

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Home Health Billing

Updated: June 2019. Learn about Humana’s guidelines for submitting claims for home health services for your patients with Medicare Advantage and commercial plans. This is an updated version of a previous presentation. It includes a printable tip sheet. Runtime: 19:00

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Humana’s Approach to Code Editing

Updated: May 2019. Learn about Humana’s approach to code editing for claims for your patients with Humana Medicare Advantage, commercial and Medicaid plans. This presentation includes a printable overview. Runtime: 11:41

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Humana’s Maximum Unit Values

Updated: May 2019. Learn about Humana’s approach to maximum unit values for your patients with Humana Medicare Advantage, commercial and Medicaid plans. This presentation includes a printable tip sheet. Runtime: 12:08

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Application of Medicare NCD/LCD Guidelines

Updated: May 2019. Learn how Humana administers Medicare national coverage determinations (NCDs), local coverage determinations (LCDs) and related articles for Medicare Advantage plans. This presentation includes a printable tip sheet. Runtime: 12:07

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Modifiers 59 and X{EPSU}

Updated: April 2019. Learn about Humana’s policy on the use of Modifier 59 and the X{EPSU} modifiers. This information applies for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. A printable tip sheet is included. Runtime: 14:07

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Claim Disputes and Corrected Claims

Released: March 2019. Learn about Humana’s processes for medical claim disputes and corrected claims. This information pertains to claims submitted for your patients with Humana Medicare Advantage and commercial plans. This presentation includes a printable tip sheet. Runtime: 13:32

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Modifier 24

Updated: March 2019. Learn about Humana’s policy on the use of Modifier 24 to indicate an unrelated evaluation and management (E/M) service by the same physician or other qualified healthcare professional during a postoperative period. This information applies to patients with Humana Medicare Advantage and commercial plans. A printable tip sheet is included. Runtime: 10:34

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Bilateral Services and Modifier 50

Updated: December 2018. Learn about Humana’s policies for reporting bilateral services and the use of modifier 50 for services provided to Medicare Advantage, commercial and select Medicaid members. This presentation includes a printable tip sheet. Runtime: 9:49 minutes

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Understanding an Explanation of Remittance (EOR)

Released: December 2018. Understand your Humana EOR for your patients with Humana Medicare Advantage, commercial and Medicaid plans. This presentation includes a printable tip sheet. Runtime: 16:11 minutes

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Chronic Care Management Services

Updated: October 2018. Learn about Humana’s policy for chronic care management services codes when submitting claims for your patients with Humana Medicare Advantage and select Medicaid plans. This presentation includes a printable tip sheet. Runtime: 11:57 minutes

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Common Errors — Reporting Diagnosis Codes in the Primary Position

Updated: August 2018. Learn how to avoid some common errors when reporting primary diagnosis codes for claims submitted for your patients with Humana Medicare Advantage, commercial and Medicaid plans. This is an updated version of a previous presentation, “Primary Diagnosis Codes — Common Reporting Errors.” This presentation includes a printable tip sheet. Runtime: 15:58 minutes

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Tools and Resources for Healthcare Providers

Updated: August 2018. Learn about Humana’s inventory of useful tools and resources, which can simplify your claims-related and other interactions with Humana. Printable resource guides are included. Runtime: 10:41 minutes

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Modifier 25

Updated: August 2018. Learn about Humana’s policy on the use of modifier 25 when submitting claims for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This is an updated version of a previous presentation. It includes a printable tip sheet. Runtime: 12:02 minutes

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Drug Testing and Codes (2017–2018)

Updated: July 2018. Learn about Humana’s policies on drug testing for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This is an updated version of a previous presentation. It includes a printable tip sheet. Runtime: 17:05 minutes

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Modifiers 96 and 97 (Habilitative and Rehabilitative Services)

Released: June 2018. Learn about Humana’s new policy requiring the use of modifiers 96 and 97 (habilitative and rehabilitative services) when submitting claims for many of your patients with Humana commercial plans. This presentation includes a printable tip sheet. Runtime: 8:42 minutes

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Professional Component/Technical Component

Updated: June 2018. Learn about Humana’s policies for proper reporting and reimbursement of the professional and technical components of a service for your patients with Humana Medicare Advantage, commercial and select Medicaid plans. This is an updated version of the previous presentation. It includes a printable tip sheet. Runtime: 11:38 minutes

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Multiple Evaluation and Management (E/M) Services

Updated: April 2018. Learn about Humana’s policies for reimbursement of multiple E/M services for physicians and other professional providers submitting claims for patients with Humana Medicare Advantage, commercial and select Medicaid plans. This presentation includes a printable tip sheet. Runtime: 12:38 minutes

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Medicare Preventive Services

Updated: November 2017. Learn about Humana’s policies for coverage of preventive services for your patients with Humana Medicare Advantage plans. Topics covered include the Initial Preventive Physical Examination, Annual Wellness Visit, Annual Preventive Physical Exam and Well Woman Exam. This presentation includes a printable tip sheet. Runtime: 21:57 minutes

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Disclaimer: The information in these presentations is general and does not represent individual member benefits, coverage or payment determinations made by Humana; nor does it supersede any determination made by Humana. It does not guarantee claim payment and should not be used as legal advice or a legal opinion. As claims policies and guidelines change, the information in these presentations may be updated to reflect those changes. For Humana member claim or benefit information, please call the number on the back of the member’s ID card.

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