gost
Guru
According to CMS, "Caution: MUEs should NOT apply to any code reported with modifier 55."
I interpret this to mean any code billed with modifier 55 should not be subject to the MUE edits as long as 55 is a valid modifier for that procedure code.
A coworker interprets to mean that MUE edits are overridden for any code billed with modifier 55 and that Medicare/Medicaid payers must allow the modifier with any code, even in modifier 55 is not a valid modifier for that code.
So far, I have been unable to get clarification from CMS. Anyone been through this and already have a response? Any opinions?
I wasn't sure which forum to post this in so it's in several. Sorry for the redundancy.
I interpret this to mean any code billed with modifier 55 should not be subject to the MUE edits as long as 55 is a valid modifier for that procedure code.
A coworker interprets to mean that MUE edits are overridden for any code billed with modifier 55 and that Medicare/Medicaid payers must allow the modifier with any code, even in modifier 55 is not a valid modifier for that code.
So far, I have been unable to get clarification from CMS. Anyone been through this and already have a response? Any opinions?
I wasn't sure which forum to post this in so it's in several. Sorry for the redundancy.