Beatriz Almeida

CLM-2026-9120, BCBS, X-Ray Foot, Complete (73630)

In appealWith the payer Denied claims

Billed

$1,085

denied May 18

Denial risk

70%

winnable with the right notes

Appeal window

lapsed

closes Aug 16

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
May 18
Denied by BCBS
Medical Necessity (50)
May 18
Heron scored it: 70% denial risk
3 factors found, appeal path chosen
May 18

The denial

Medical Necessity, code 50

Patient: Beatriz Almeida, born 1984-10-12
Payer: BCBS
Procedure: X-Ray Foot, Complete (73630)
Diagnosis: M79.671
Denied on: May 18, 2026
Assigned to: Heron

Heron says

BCBS denies 50% of 73630 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.