Humana differ from AMA CPT Coding guidelines
The below list of code combinations that Humana has determined are not appropriately reported together with a modifier 59 and which differ from AMA CPT coding guidelines.
Modifier 59 Edits (as of October 31, 2008)
Humana utilizes the following code-editing logic:
CPT code 63042 appended with modifier 59 will not be reimbursed when submitted with 22630.
CPT code 44005 appended with modifier 59 will not be reimbursed when submitted with 57285.
CPT code 44005 appended with modifier 59 will not be reimbursed when submitted with 57423.
CPT code 29877 appended with modifier 59 will not be reimbursed when submitted with 29880.
CPT code 29877 appended with modifier 59 will not be reimbursed when submitted with 29881.
Please note: The policies and guidelines addressed above are not an all-inclusive listing.
Reference:http://apps.humana.com/marketing/documents.asp?file=1104571
