88342 MUE limit of 3

annettebec

Networker
Messages
58
Location
Swartz Creek, MI
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0
Medicare, BlueCross are denying any quantity over 3. However, we have 6 specimens with a stain performed on each specimen. We are reporting out 88342 x 6. Medicare and Blue CRoss are only paying 3. We have tried Line 1 88342 3 units, Line 2 88342-XS 1 unit, 88342-XS 1 unit, 88342-XS 1 unit and we have tried modifier 59. Is anyone else having this issue and if so how are you getting your claim paid. Any help appreciated.
 

Pam Crose

New
Messages
6
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0
I would suggest sending the actual path report to the insurance company to show justification for performing the testing.
 
Messages
3
Location
Kingsport, TN
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0
We had the same problem we started billing one 88342 per line with a XS modifier. This seems to work most of the time, when it doesn't we send a coded pathology report showing the specimens and immune's. Hope this helps!
 
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