ollielooya
True Blue
Hmmmmm, found this MCR modifier and am tempted to use it. I am fully aware of what the NCCI policy statement has to say concerning the MUE'S, but this is a specific modifier used to "over-ride" the edits IF the situation is medically necessary, so not a violation of the policy to do so.
GD: Units of service exceeds medically unlikely edit value and represents reasonable and necessary services. Currently only CMS is using medically unlikely edits. Medically unlikely edits are not released by CMS nor commercially available. The provider documentation must support the medical necessity of exceeding the MUE (extracted from Understanding Modifiers 2010 from Ingenix).
I find this very interesting. Noticed National Government Services do not have this modifier included in their list at their website. I put in this question to another forum I frequent and received limited response. How about this forum? Anyone actually use this with success? Better yet, have others even heard or known about this one?
GD: Units of service exceeds medically unlikely edit value and represents reasonable and necessary services. Currently only CMS is using medically unlikely edits. Medically unlikely edits are not released by CMS nor commercially available. The provider documentation must support the medical necessity of exceeding the MUE (extracted from Understanding Modifiers 2010 from Ingenix).
I find this very interesting. Noticed National Government Services do not have this modifier included in their list at their website. I put in this question to another forum I frequent and received limited response. How about this forum? Anyone actually use this with success? Better yet, have others even heard or known about this one?