September 22, 2022
When billing 4 units of 11620 (4 charges with 1unit a piece with 76 modifier) to a Medicare Advantage plans we are getting denied for MUE stating that 3 units can only be reimbursed on the same date. Will changing the modifier to 59 bypass this edit or is it Medicare’s policy limit.
An MUE of 3 is the maximum number of units you can report for a single beneficiary on a single date of service for the procedure. It would be inappropriate to bill the service with 4 units with Modifier 59.
*This response is based on the best information available as of 09/22/22.