Wiki Medicare MUE's

RhondaW

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Bennington, NE
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Example: A Medicare patient comes in after a fall at home with injury. The ER doctor orders a single view pelvis to determine if there is a fracture. The report is negative for fracture. The patient is a full admission and complains of continued hip/pelvic pain so the attending orders another single view pelvis on the same day. Our claim scrubber will not allow us to bill the second pelvic x-ray due to a MUE stating only one should be done per day. Is it appropriate to bill the second pelvic x-ray, get the denial and then adjust it? Or should we not bill the second x-ray to avoid a denial? :confused:
 
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