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Wiki Exceeding MUE

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bmanus

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Mount Pleasant, NC
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Good Afternoon,

I have a surgeon who has performed 5 separate 14060s. Medicare has an MUE of 4. My surgeons would like to bill the 5th as an excision and a complex repair. My question is since it clearly states "advancement flap tissue rearrangement on all 5 can we bill it as anything other than a flap?
It does state on one that "-0 Vivryl sutures were place throught the deep subcutaneous tissure and the flap.

Thank you in advance for your help.
 
Just because something is medically unlikely doesn't mean it can't be billed. My recommendation would be to bill all 5 and then appeal the denial with notes. My guess is that this would be paid on appeal.
 
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