Forum - Questions & Answers
multiple unit billing
hello all!
I bill multiple units of these codes for an audiologist/ENT/balance spec. on a regular basis: 92542, 92543, 92544, 92545, 92546 and 92548. I find that Medicare and some insurances will not pay these multiple units even when using a 59 or 22 modifier. I send medical records and test results. Are there different codes to be used, signifying multiple units done? Am I using the wrong modifier? I would appreciate any feedback.
Have a great day!
re: multiple unit billing
Medicare only allows 1 unit for codes 92542, 92544, 92545, 92546, and 92549/per day. Medicare allows 4 units/per day for code 92543.
re: multiple unit billing
thanks for the reply!
thats what i've been seeing, but is that a definitive rule? i was told that there are modifiers to use.
will using a -76 or -91 modifier affect reimbursement? i have documentation/med rec to back it up. i was thinking that i should bill the first unit of those codes with a -59 and the additional units using -76 or -91 as a separate line item for each unit.
thx
re: multiple unit billing
For Medicare it is definite. It is part of their MUE frequency edits
re: multiple unit billing
ok, great, thanks again!