Wiki MUE Edits

[g01476894]

I have this MUE edits sheet for Pathology CPT codes for reference and below is the case I have come across:

For CPT 88304, allowed unit per DOS is 4 units as per MUE list
and I have 6 units of 88304 for that DOS?

Which modifier is to be appended?

Which modifier is to be appended when initial 4 units is billed by Physician 1 and remaining 2 units billed by Physicisn 2 for SAME DOS?

Which modifier is to be appended when initial 3 units is billed by Physician 1 and remaining 3 units billed by Physicisn 2 for SAME DOS?

Please help.

 

[CodingKing]

Over MUE you need to wait for a denial and submit an appeal. This is a per day MUE so you should not be splitting to bypass the edit.

 

[g01476894]

Thank you for the reply.


"This is a per day MUE so you should not be splitting to bypass the edit."

Does the above statement mean that we dont have consider the physician but the number of times the procedure performed?