Ravi Menon

CLM-2026-9167, Aetna, MRI Lower Extremity Joint (73721)

DeniedWith me Denied claims

Billed

$4,298

denied Aug 19

Denial risk

44%

good odds

Appeal window

79d

closes Nov 17

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Aug 19
Denied by Aetna
Bundling/Coding Error (97)
Aug 19
Heron scored it: 44% denial risk
3 factors found, appeal path chosen
Aug 19
Appeal window closes
79 days left to file
Nov 17

The denial

Bundling/Coding Error, code 97

Patient: Ravi Menon, born 1987-01-14
Payer: Aetna
Procedure: MRI Lower Extremity Joint (73721)
Diagnosis: M23.61
Denied on: Aug 19, 2026
Assigned to: Heron

Heron says

Aetna 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

I can draft one from this claim's history

Draft it View the claim form

Open Intelligence, pick this claim, and I write the letter from the denial, the payer's rules and the clinical guideline. You sign it here.

What I sent

Corrected claim

Everything I know about Ravi

across every queue

Everything for this patient

Open exposure

$27,058

Recovered

$12,754

5 denied claims5 prior auths3 underpayments2 backlog claims

AUTH-4085

72148 · MRI Lumbar Spine w/o Contrast

73721 · MRI Lower Extremity Joint

70553 · MRI Brain w/ and w/o Contrast

73721 · Bundling/Coding Error

96417 · Chemotherapy, Additional Sequential

72148 · MRI Lumbar Spine w/o Contrast

96417 · 31d outstanding

73721 · Medical Necessity

72148 · underpaid 17%

73721 · Missing Information

72148 · 149d outstanding

72148 · underpaid 10.6%

72148 · underpaid 14.6%

97110 · Medical Necessity

96413 · Missing Information

$10,662

Recovered

Nov 22