Notification Number: 1610
Effective date: 4/5/2014
Category: Correct Coding
Topic: Routine Nursing Included in Room and Board
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.
Claim edits do not supersede the necessity to obtain preauthorization. Preauthorization requirements are still applicable. Modifiers should be used when appropriate to accurately represent the services rendered. The use of modifiers may impact Humana’s application of these edits. For additional information, consult professional coding resources.
*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.