Robin Posted Tue 24th of January, 2012 01:56:38 AM
ONe of the doctors in our practice is insisting on billing for a 31622 done two times in the same day. how can we do this
SuperCoder Answered Sat 28th of January, 2012 20:46:50 PM
31622 has a Medically Unlikely Edit number of 1, meaning it should only be billed once per day.
Now, you need to bypass the edits to bill it twice on same DOS,and for that you should be able to bypass edits with justification as per bypassing guidelines mentioned below.
BYPASSING MUE EDITS:
CMS has provided guidance that MUEs are to be adjudicated separately against each line on a claim rather than the entire claim. This process is triggered by appending an appropriate modifier to more than one line on a claim reporting the same CPT code. CPT modifiers such as 76 (repeat procedure by same physician), 91 (repeat clinical diagnostic laboratory test), and 59 (distinct procedural service) will accomplish this purpose. However, providers should be aware that modifier 59 is the modifier of last resort and should only be used if no other modifier describes the service.
Dena Answered Wed 01st of February, 2012 00:17:37 AM
We have billed this code twice in the same day with a 76 modifier and chart notes. It is extremely rare but it has happened.