Wiki Modifer


A Medically Unlikely Edit (MUE) is a US Medicare unit of service claim edit applied to Medical claims against a procedure code for medical services rendered by one provider/supplier to one patient on one day.
Your question is fairly vague. Why is the patient having multiple ultrasounds on the same day? Ultrasound of what? Same CPT, different CPT code? Then there is the medical necessity and whether they qualify as separately reportable even with modifier 59. I don't think the fact its Independence Blue Cross makes much of a difference either. There is no one answer, specifics matter
This is a maternal fetal medicine dr and her pt's are all high risk. There are different codes in which she uses. 76817, 76818, 76820 and 76819. They're done in the same day, but she's looking for different things. Does that make sense?