A colleague said you need to understand what a MUE is and sure enough an insurance denied CPT 64455 when billed with RT snd LT on two lines, the denial was based on its MUE, please explain?
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MUE - Medically Unlikely Edits. MUE’s - are edits from CMS that limit the number of times you can perform a specific CPT code on a given date of service. E.g. you perform one CPT 11730 (MUE=1) ingrown toenail removal and six CPT 11732 (MUE=4) - additional ingrown toenail removals, with the Medicare contractor (MAC) will assign the denial code CO-151 for too many procedures performed on CPT 11732.Now let's take CPT 64455, it has MUE=1 and has a bilateral indicator, this means you can bill CPT 64455 1 UNIT but use modifier 50 and double your fee to get paid for 2 feet. If you use two lines it will always be denied based on not following this knowledge.