tci Outpatient Facility Coding Alert - 2020 Issue Q1

Reader Question: Know How MUEs Can Affect Bilateral Billing

Question: Why might I be receiving a denial for frequency when submitting two units of 30140 with modifiers LT and RT to Medicare? Tennessee Subscriber Answer: The bilateral surgery indicator of “1” indicates you can bill 30140 (Submucous resection inferior turbinate, partial or complete, any method) as a bilateral procedure. In this scenario, the obvious culprit may refer back to the code’s medically unlikely edits (MUEs). You’ll see that 30140 has an MUE of 1, which means that only one unit of 30140 may be submitted to the payer on a given date of service (DOS)...

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