Rosa Delgado

CLM-2026-9043, Cigna, Manual Therapy, 15 min (97140)

RecoveredWith me Denied claims

Billed

$1,335

denied Jan 28

Denial risk

68%

winnable with the right notes

Appeal window

closed

nothing left to file

Recovered

$1,335

the money is back

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Jan 28
Denied by Cigna
Medical Necessity (50)
Jan 28
Heron scored it: 68% denial risk
3 factors found, appeal path chosen
Jan 28
Paid in full
The money is back
May 15

The denial

Medical Necessity, code 50

Patient: Rosa Delgado, born 1966-08-14
Payer: Cigna
Procedure: Manual Therapy, 15 min (97140)
Diagnosis: M54.2
Denied on: Jan 28, 2026
Assigned to: Heron

Appeal successful, payment posted

Heron says

Cigna denies 38% of 97140 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.