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Limitations for CPT codes 17263

  1. #1
    Default Limitations for CPT codes 17263
    Medical Coding Books
    My provider did electrodesiccation and curettage x 5 lesions from the trunk. We billed 17262
    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.

  2. #2
    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:

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