Wiki Exceeding MUE

[bmanus]

Good Afternoon,

I have a surgeon who has performed 5 separate 14060s. Medicare has an MUE of 4. My surgeons would like to bill the 5th as an excision and a complex repair. My question is since it clearly states "advancement flap tissue rearrangement on all 5 can we bill it as anything other than a flap?
It does state on one that "-0 Vivryl sutures were place throught the deep subcutaneous tissure and the flap.

Thank you in advance for your help.

 

[espressoguy]

Just because something is medically unlikely doesn't mean it can't be billed. My recommendation would be to bill all 5 and then appeal the denial with notes. My guess is that this would be paid on appeal.

 

[bmanus]

Thank you. That was my orginial plan.