Hannah Kowalczyk

CLM-2026-9072, Medicare, MRI Lower Extremity Joint (73721)

RecoveredWith me Denied claims

Billed

$4,167

denied Mar 18

Denial risk

65%

winnable with the right notes

Appeal window

closed

nothing left to file

Recovered

$4,167

the money is back

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Mar 18
Denied by Medicare
Medical Necessity (50)
Mar 18
Heron scored it: 65% denial risk
3 factors found, appeal path chosen
Mar 18
Paid in full
The money is back
May 24

The denial

Medical Necessity, code 50

Patient: Hannah Kowalczyk, born 1955-05-10
Payer: Medicare
Procedure: MRI Lower Extremity Joint (73721)
Diagnosis: M23.61
Denied on: Mar 18, 2026
Assigned to: Heron

Appeal successful, payment posted

Heron says

Medicare denies 45% of 73721 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.