Jonah Weiss

CLM-2026-9132, Cigna, Chemotherapy, Additional Sequential (96417)

In appealWith the payer Denied claims

Billed

$6,346

denied Jun 3

Denial risk

57%

winnable with the right notes

Appeal window

closes Sep 1

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Jun 3
Denied by Cigna
Medical Necessity (50)
Jun 3
Heron scored it: 57% denial risk
3 factors found, appeal path chosen
Jun 3

The denial

Medical Necessity, code 50

Patient: Jonah Weiss, born 2005-05-15
Payer: Cigna
Procedure: Chemotherapy, Additional Sequential (96417)
Diagnosis: C18.9
Denied on: Jun 3, 2026
Assigned to: Heron

Heron says

Cigna denies 45% of 96417 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.