Heron

Quentin Moreau

CLM-2026-9064, Aetna, Manual Therapy, 15 min (97140)

Written offWith me Denied claims
Billed
$1,137
denied Mar 3
Denial risk
42%
good odds
Appeal window
closed
nothing left to file
Appeals
0
none filed yet

What I did

and what comes next
  1. Claim reached Heron
    Posted from the 835 remittance
    Mar 3
  2. Denied by Aetna
    Bundling/Coding Error (97)
    Mar 3
  3. Heron scored it: 42% denial risk
    3 factors found, appeal path chosen
    Mar 3
  4. Heron
    Written off
    Every route exhausted
    Apr 25

The denial

Bundling/Coding Error, code 97

Patient
Quentin Moreau, born 1975-05-24
Payer
Aetna
Procedure
Manual Therapy, 15 min (97140)
Diagnosis
M54.2
Denied on
Mar 3, 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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View the claim form

This claim is settled, so there is nothing left to write.

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
66% odds
Approved
Jul 27
CLM-2026-9106
93306 · Not Covered
$3,334
In appeal
Jul 24
CLM-2026-5162
73721 · 67d outstanding
$2,448
Not submitted
Jun 24
CLM-2026-7058
70553 · underpaid 28.9%
$107 short
Recovered
Jun 8
CLM-2026-9127
93306 · Bundling/Coding Error
$588
In appeal
May 17
CLM-2026-5049
71046 · 113d outstanding
$1,844
Pending payer
May 9
CLM-2026-9048
97530 · Bundling/Coding Error
$834
In appeal
Apr 21
CLM-2026-5159
72110 · 176d outstanding
$1,694
Awaiting info
Mar 7
CLM-2026-9064viewing
97140 · Bundling/Coding Error
$1,137
Written off
Mar 3
CLM-2025-7031
73721 · underpaid 29.3%
$137 short
Written off
Nov 20
CLM-2025-7009
93306 · underpaid 8.8%
$70 short
Written off
Sep 27