Wiki MUE modifer for Medicare

[VickiS]

Could I get some guidance as to which modifier would be used for Medicare MUEs: example would be 88361 x8....Medicare only allows 6, so would you bill 88361x6 and then 88361x2 with a XU or 59 modifier .. path report has specimen A with 88361x4 Left Breast and specimen B with 88361x4 of Right Breast...medicare denied 88361x8.
We billed it as follows:
Specimen A: L Breast-88305,88342-XU,88361x4
Specimen B: R Breast-88305,88361x4,88374-26 x2
Specimen C: R Breast Axillary lymph node-88305
Thank you for any guidance as to which modifier should be used for MUE's.

 

[psacco]

Modifiers

These new "X" modifiers really do not work too well for pathology purposes. Where i work we usually use the XE or XU on MUE issues for medicare. Although per Medicare, if you only have 2 lines, like 88361 x 4 and 88361 x 2, you can still use the 59. But again, in my office, we are only using "X" modifiers, and for MUE it is usually only XE or XU .

 

[CodingKing]

I'm probably missing something but wouldn't specimen A & B = 2?