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Medically Unlikely Edit for ESRD Equipment
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jpositos:
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:
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.
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