Wiki Mue - I need some help with understanding

[vjefcoats]

Hello,

I need some help with understanding MUE's. I understand if the cpt code has MUE of 1 then thats all your suppose to bill..(?) We have claims denying for MUE when we bill out for facility and profee for same cpt code even though they have different revenue codes. For example: Simple repair 12002 with revenue codes 450 facility and 981 physician. The denial states need modifier for MUE. This is an emeregency dept in a critical access hospital, does that make a difference?

I would greatly appreciate any input!!
Thanks,

Vicki Jefcoats
CPC

 

[mitchellde]

check with the carrier we found that many carriers want the pro fee on a 1500 instead of using rev code 981. That was the way we did about half of ours when I worked in a level 5 trauma unit.

 

[vjefcoats]

Thank you so much for your help!!
Vicki