Wiki 26418 with MUE questions

[2rjjapetal]

Procedure
Primary repair left thumb extensor pollicis longus
Primary repair left thumb extensor carpi radialis longus
Extensor tendon repair left middle finger
Extensor tendon repair Left ring finger
Extensor tendon repair left small finger

26418 MUE is 3.. for cases where there are more than 3 how would you suggest coding
per line with finger modifier
or units (even if there are more than 3)
thanks

 

[Orthocoderpgu]

Since the repairs were performed on four separate fingers I don't think you should have an issue. However MUE is a good topic. The MUE started due to insurance fraud. Fraudulent physicians would bill out more procedures than could possible be performed on the same patient but since CMS has computers paying claims, it would send it inflated checks to physicians. Right now 20610 has an MUE of two but physically it could be performed six times on a patient, but that is very medically unlikely. Per the CMS web site any procedures performed above the MUE can be paid for with medical documentation. So say a patient has 20610 X 3, the first two would be paid initially and the third after review of medical documentation.