Author Topic: Medically Unlikely Edit for ESRD Equipment  (Read 880 times)

jpositos

  • Newbie
  • *
  • Posts: 22
Medically Unlikely Edit for ESRD Equipment
« on: September 12, 2015, 12:55:40 PM »
Hi,

I have an MUE denial for HCPCS E1510 and E1590 (dialysis machines used for treatment of ESRD patients 3X a week) with Medicare and when I looked it up these are what I found: 

MUE Value = 0
MUE Adjudication Indicator =  3 Dates of Service Edit: Clinical

Does this mean these machines are not covered at all?  OR,  Does this mean I can only bill once every 3 dates of service?  My client is a home health agency providing staff-assisted in-home dialysis only. They provide the machines to the patient as a rental.

Any info you can share is greatly appreciated.

Jocelyn

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4762
    • Solutions Medical Billing
Re: Medically Unlikely Edit for ESRD Equipment
« Reply #1 on: September 13, 2015, 01:26:36 PM »
From the information given I am not sure but I believe that it is something in the billing, not that it is not a covered service.  Have you tried calling the DME carrier and asking for an explanation?  They can usually point you to an LDC or NDC that is helpful.
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com