Wiki Mue

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asalensky

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My laboratory has developed a new panel in which there are 14 pathogens being tested that fall under the non-specific code 87798. The MUE for this code is 13. Can we only bill for 13 units of 87798 even though we are performing 14 units of 87798?
 
For 87798, the professional MUE is 13 with an MAI of 3- Clinical Data. With this MAI, the only option is to appeal with supporting documentation. However, from the facility the MUE is 21. If you are billing for the facility you should not have any issue.
 
Thank you for your response. We are an independent clinical laboratory billing on CMS 1500.
 
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