Wiki 82272 units

[tdelozier16]

I have been receiving denials from Humana stating that "THESE SERVICES EXCEED THE MAXIMUM NUMBER OF TIMES THAT A PROCEDURE MAY BE REPORTED ON A SINGLE DATE." for 82272. The claim has 82272 and for the units, they are putting 3 units. I am thinking that this is wrong since 82272 covers 1-3 cards. Wouldn't the units only be 82272 x 1 when billed on a claim?

 

[sls314]

I have been receiving denials from Humana stating that "THESE SERVICES EXCEED THE MAXIMUM NUMBER OF TIMES THAT A PROCEDURE MAY BE REPORTED ON A SINGLE DATE." for 82272. The claim has 82272 and for the units, they are putting 3 units. I am thinking that this is wrong since 82272 covers 1-3 cards. Wouldn't the units only be 82272 x 1 when billed on a claim?

You are correct. 82272 has an MUE value of 1.

They'll get automatic rejections billing more than one unit, and there would be no justification to appeal an MUE denial because the definition of the code includes 1-3 simultaneous determinations.