Isabel Carvalho

CLM-2026-9031, UnitedHealthcare, X-Ray Lumbar Spine, 4+ Views (72110)

In appealWith the payer Denied claims

Billed

$1,031

denied Jun 24

Denial risk

56%

winnable with the right notes

Appeal window

23d

closes Sep 22

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Jun 24
Denied by UnitedHealthcare
Medical Necessity (50)
Jun 24
Heron scored it: 56% denial risk
3 factors found, appeal path chosen
Jun 24

The denial

Medical Necessity, code 50

Patient: Isabel Carvalho, born 1989-06-08
Payer: UnitedHealthcare
Procedure: X-Ray Lumbar Spine, 4+ Views (72110)
Diagnosis: M54.51
Denied on: Jun 24, 2026
Assigned to: Heron

Heron says

UnitedHealthcare denies 55% 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.