Mateo Fuentes

CLM-2026-9084, Medicare, X-Ray Lumbar Spine, 4+ Views (72110)

In reviewWith you Denied claims

Billed

$840

denied Jul 29

Denial risk

70%

winnable with the right notes

Appeal window

58d

closes Oct 27

Appeals

none filed yet

What I did

and what comes next

Claim reached Heron
Posted from the 835 remittance
Jul 29
Denied by Medicare
Medical Necessity (50)
Jul 29
Heron scored it: 70% denial risk
3 factors found, appeal path chosen
Jul 29
Appeal window closes
58 days left to file
Oct 27

The denial

Medical Necessity, code 50

Patient: Mateo Fuentes, born 1951-06-19
Payer: Medicare
Procedure: X-Ray Lumbar Spine, 4+ Views (72110)
Diagnosis: M54.51
Denied on: Jul 29, 2026
Assigned to: Heron

Heron says

Medicare denies 46% 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.