tci Medicare Compliance & Reimbursement - 2007 Issue 44

CCI edits: New Modifier Makes MUEs More Palatable in 2008

Append GD to thwart medically unlikely edits If you need a way to override a medically unlikely edit, HCPCS offers you a new modifier effective Jan. 1. Starting in January, the medically unlikely edits (MUEs) will limit the number of units of a particular code that your physician can bill. To avoid MUE-related denials, you can now append new HCPCS modifier GD (Units of service exceed MUE value but represent medically necessary services) to your claim. CMS has not yet announced whether this modifier will apply to both CPT and HCPCS codes. But assuming it does, modifier GD could...

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