Marcus Oyelaran

CLM-2026-9115, Aetna, X-Ray Lumbar Spine, 4+ Views (72110)

DeniedWith me Denied claims

Billed

$2,041

denied Aug 24

Denial risk

57%

winnable with the right notes

Appeal window

84d

closes Nov 22

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Imported from a CSV export
Aug 24
Denied by Aetna
Medical Necessity (50)
Aug 24
Heron scored it: 57% denial risk
3 factors found, appeal path chosen
Aug 24
Appeal window closes
84 days left to file
Nov 22

The denial

Medical Necessity, code 50

Patient: Marcus Oyelaran, born 2001-10-13
Payer: Aetna
Procedure: X-Ray Lumbar Spine, 4+ Views (72110)
Diagnosis: M54.51
Denied on: Aug 24, 2026
Assigned to: Heron

Heron says

Aetna denies 48% of 72110 claims without documented conservative treatment. Clinical notes supporting medical necessity were not attached to the original submission. Attach treatment history and imaging before appealing, overturn rate rises sharply with documentation.