Quentin Moreau

CLM-2026-9048, Aetna, Therapeutic Activities, 15 min (97530)

In appealWith the payer Denied claims

Billed

$834

denied Apr 21

Denial risk

47%

good odds

Appeal window

lapsed

closes Jul 20

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Entered by hand
Apr 21
Denied by Aetna
Bundling/Coding Error (97)
Apr 21
Heron scored it: 47% denial risk
3 factors found, appeal path chosen
Apr 21

The denial

Bundling/Coding Error, code 97

Patient: Quentin Moreau, born 1975-05-24
Payer: Aetna
Procedure: Therapeutic Activities, 15 min (97530)
Diagnosis: M62.81
Denied on: Apr 21, 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

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Draft it View the claim form

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What I sent

Corrected claim

Everything I know about Quentin

across every queue

Everything for this patient

Open exposure

$10,742

Recovered

$107

4 denied claims1 prior auth3 underpayments3 backlog claims

AUTH-4060

73721 · MRI Lower Extremity Joint

73721 · 67d outstanding

70553 · underpaid 28.9%

93306 · Bundling/Coding Error

71046 · 113d outstanding

97530 · Bundling/Coding Error

72110 · 176d outstanding

97140 · Bundling/Coding Error

73721 · underpaid 29.3%

93306 · underpaid 8.8%

$70 short

Written off

Sep 27