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Wiki Limitations for CPT codes 17263

NESmith

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Zephyrhills, FL
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My provider did electrodesiccation and curettage x 5 lesions from the trunk. We billed 17262
17263
17263-5976
17263-5976
17263-5976
Medicare paid 17262 @ allowable, 17263-5976 @ allowable & 17263-5976 @ multiple surgery guidelines. Medicare denied two of the 17263 because they state it exceeds the limitations. First I thought if these were the only procedures done that day then there would not be a multiple surgery reduction and how do you know what the limitations are? Do you know where I might find this information? Thanks for your help as always.
 
My first inclination is that they are referring to Medically Unlikely Edits. MUE's are "the maximum units of service that a provider would report under most circumstances for a single beneficiary on a single date of service," but I'm not seeing where the codes you've listed have any MUE's.

Here is a link to Medicare's website in reference to MUE's:

http://www.cms.gov/NationalCorrectCodInitEd/08_MUE.asp
 
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