Aiko Tanaka

CLM-2026-9141, UnitedHealthcare, X-Ray Foot, Complete (73630)

In appealWith the payer Denied claims

Billed

$2,162

denied Jan 13

Denial risk

43%

good odds

Appeal window

lapsed

closes Apr 13

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Imported from a CSV export
Jan 13
Denied by UnitedHealthcare
Bundling/Coding Error (97)
Jan 13
Heron scored it: 43% denial risk
3 factors found, appeal path chosen
Jan 13

The denial

Bundling/Coding Error, code 97

Patient: Aiko Tanaka, born 1981-01-08
Payer: UnitedHealthcare
Procedure: X-Ray Foot, Complete (73630)
Diagnosis: M79.671
Denied on: Jan 13, 2026
Assigned to: Heron

Heron says

UnitedHealthcare bundled this line into a primary procedure billed the same day. Modifier review recommended, most bundling denials resolve on corrected resubmission. Verify NCCI edit pairs before resubmitting to avoid a second rejection.

No appeal yet

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What I sent

Corrected claim

Everything I know about Aiko

across every queue

Everything for this patient

Open exposure

$15,225

Recovered

$1,764

6 denied claims2 prior auths6 underpayments2 backlog claims

AUTH-4001

70553 · MRI Brain w/ and w/o Contrast

72148 · MRI Lumbar Spine w/o Contrast

93000 · 37d outstanding

71046 · underpaid 24.5%

73630 · underpaid 20.9%

93306 · Bundling/Coding Error

93015 · Medical Necessity

97140 · Pre-Auth Missing

97530 · 101d outstanding

70553 · underpaid 15.8%

72148 · underpaid 30.2%

93000 · Medical Necessity

73630 · Bundling/Coding Error

93000 · Medical Necessity

93000 · underpaid 10.6%

73630 · underpaid 10.8%

$28 short

Recovered

Oct 10