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Pulmonology Coding Alert

You Be the Coder:

Are You Checking Your MUEs?

Published on Mon Aug 10, 2020

Question: We billed a patient’s insurance plan for 92 units of allergy immunotherapy using code 95165, and the health plan paid for 30 units but denied the remaining 62 units saying that the benefit maximum had been reached. How do I know if the 30 units counts as the maximum per day, per month, or per year? Tennessee Subscriber Answer: [...]
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