Interesting clawback from Humana

Got a "refund request" from our good friends at Humana today. Clawing back two 99204s and one 99214 because "diagnosis code(s) are inappropriate". The only code all three charts have in common is G894 chronic pain syndrome. None of them use it as a primary or even secondary diagnosis, but as a 3rd or 5th diagnosis. Just a heads up don't use that code at all for Humana pts.
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums