WendyH_53178
New member
A co worker and I are at odds over MUE over certain codes and how they can be billed for our orthopedic hand surgeons.
CPT code 26145 shows MUE of 6 units. I am saying that 6 is the maximum number of units to be billed per day. My co-worker is stating that you can bill up to 6 units per day for each finger modifier that it shows on Codify, Encoder, etc .
I was always under the impression the modifiers are there as a guide and not as a per unit.
Same goes for CPT code 26440- description says each tendon with MUE of 6. She states we can bill 26440 F1 -6 units 26440 F2- 6 units Etc.... Where I on the other hand say you can bill 26440 with the modifier that represents the finger or hand up to a maximum of 6 total.
Our doctor is stating that they did in fact do more than 6 so we can bill it. I’ve tried explaining CMS and that they have the final say, but they feel it is not a concrete answer. I’ve also explained once it hits the clearinghouse it will be denied for maximum units. Am I misinterpreting this ? I hope this makes some sense. We are at odds and unable to come to a clear answer.
CPT code 26145 shows MUE of 6 units. I am saying that 6 is the maximum number of units to be billed per day. My co-worker is stating that you can bill up to 6 units per day for each finger modifier that it shows on Codify, Encoder, etc .
I was always under the impression the modifiers are there as a guide and not as a per unit.
Same goes for CPT code 26440- description says each tendon with MUE of 6. She states we can bill 26440 F1 -6 units 26440 F2- 6 units Etc.... Where I on the other hand say you can bill 26440 with the modifier that represents the finger or hand up to a maximum of 6 total.
Our doctor is stating that they did in fact do more than 6 so we can bill it. I’ve tried explaining CMS and that they have the final say, but they feel it is not a concrete answer. I’ve also explained once it hits the clearinghouse it will be denied for maximum units. Am I misinterpreting this ? I hope this makes some sense. We are at odds and unable to come to a clear answer.