Urology Coding Alert

Reader Questions:

Consider Modifier Switch for Bilateral Billing of 1 MUE Codes

Question: Why might I be receiving a denial for frequency when submitting two units of a 54522 with modifiers LT and RT to Medicare? Tennessee Subscriber Answer: The bilateral surgery indicator of “1” indicates you can bill 54522 (Orchiectomy, partial) as a bilateral procedure. In this scenario, the obvious culprit may refer back to the code’s medically unlikely edits (MUEs). [...]
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