Wiki H2019 Duplicate Denial

smitkaty

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A client is billing for H2019 services done in two different settings for the two claims, different encounters, same patient, same date of service, same practitioner. Only difference is that the place of service code is different, the units, and the charge amount. I have suggested that they use an XE modifier given the same patient, same service, same date of service and same practitioner - different encounter; and they're arguing that since no MUE exists they shouldn't have to use.

Aren't MUE's outside of coding rules? I mean shouldn't the fact that it meets criteria for the XE apply, regardless of MUE edit status?

Thanks for any help you can provide!
 
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