Wiki 83992 code issue

[metzger130]

We have been billing 83992 with 2 units to insurances that take the 803xx codes. Recently Medical Mutual told us that they only accept 1 unit a day on this and are doing a take back for all of them that they paid incorrectly over the last year. I asked for information and they cold not tell me where to find this is writing. Another person here called them with same result. Does anyone know of any other insurance companies other than medical mutual that only accepts 1 unit. I looked in the COT book and it has 2 (3) for the MUE of the code so I do not see a reason that 2 units would not be allowed.

Thank you

 

[marvelh]

Per CPT Section Guidelines for Definitive Drug Testing - "Each category of a drug class, including metabolite(s) if performed (except stereoisomers), is reported once per date of service." The 83992 is included in the Definitive Drug Testing CPT section and as such the above limitation would apply.

 

[metzger130]

That makes sense, but why is the MUE 2 then instead of 1? When I look at the MUE table and it says 2, I would say that you can do 2 units.