• Lesion Removal MUEs


    Patient had lesions removed on all four eyelids. MUE states it is three. Can we bill two separate line items each with a -50 modifier?

    Who is the payer and what are their billing preferences? With an MUE of three, you may bill up to three units per eye.
    Payers may require modifier -50, -RT, -LT, or the eyelid modifiers; -E1, -E2, -E3, -E4.

    From the Coding Coach Clues: 
    • Sutures, if necessary, are not separately payable.
    • For Medicare Part B patients, when surgery is performed bilaterally, submit one line item with the surgical code appended by modifier -50, per Medically Unlikely Edits (MUEs) effective April 1, 2013. A 1 should be placed in the unit field and the charge doubled.
    Coding Coach: The Complete Ophthalmic Coding Reference (aao.org)