About Us

Back To Claim Processing Edits 


Code edit notification

Notification Number: 1276

Effective date: 1/26/2013

Notification date: 10/26/2012

Category: Correct Coding

Topic: Routine Nursing Included in Room and Board

Providers affected:

  • Inpatient/Outpatient Facilities
What is changing?
According to Humana payment policies and the uniform billing (UB) editor, routine nursing services are included in the reimbursement for room and board. Therefore, routine nursing services will not be separately reimbursed.
Why is Humana implementing this change?
Humana periodically updates its policies and claims payment systems to be aligned with correct-coding initiatives as well as national benchmarks and industry standards.

Impacted products

  • Select self-funded* products
  • Commercial fully insured products


*All edits previously posted on Humana.com/providers for fully insured commercial Humana members may be applied to self-funded members, when requested by the self-funded group.