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Code edit notification

Notification Number: 1610

Effective date: 4/5/2014

Notification date:

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.

Note: This item implemented on Jan. 26, 2013 for commercial fully insured and select self-funded products.

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

  • Medicare Advantage HMO products
  • Medicare Advantage PFFS products
  • Medicare Advantage PPO 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.