Wiki Alabama Medicare Part B

[casslouch]

billing for ENG 92540, 92547x5, 92543x4
92547 w/ 5 units is being denied for exceeded units/days. Until the last 30 days we have always billed this in units. Should this be billed in individual lines?
92547
92547-59
92547-59
92547-59
92547-59
That was the advice of my Medicaid Rep when Medicaid denied for the same reason. 92543 is also billed with multiple units and that is paying properly. I am lost on this. Need some experienced advice please.

 

[Amy Pritchett]

Have you checked the MUE list for 10/2014 on the CMS website? There have been some changes and this may have been one of them

I have attached the MUE from 10/2014 for your review. Hope it helps you with this issue

http://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/MUE.html
Scroll to the bottom and click Facility Outpatient Services MUE Table Updated 10/1/14

 

[Candice_Fenildo]

The MUE has been changed effetive 10.1.2014 to a (1)

Medicare will not pay for any units other then the first one for CPT 92547.

I was reading the proposal back in September. It is because most of the ENG's are electronic and the "Electrodes" truly arent being placed anymore.