Wiki 76498

[gvelasco200@yahoo.com]

Hello I can use an experts help Please, does anyone know if 76498 May be billed twice in a Day ( AM/PM ) For Rad ONC TX .Using Mod 76/77 .

 

[thomas7331]

This code, like most other unlisted codes, has a MUE indicator of one, so will be denied by Medicare and payers that follow their guidelines if billed more than once per date of service. However, the edit is based on clinical data, so the denial can be appealed if the documentation supports the additional unit(s).

You can find the Medicare guidance and additional information on MUE edits here: https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/MUE