tci Outpatient Facility Coding Alert - 2020 Issue Q1

You Be the Coder: Check MUEs for Upper, Lower Labial Frenum Incision

Question: The surgeon documents an incision of the labial frenum for both upper and lower lip. Can I bill for this twice? Minnesota Subscriber Answer: The code you’re looking to report for an incision of the labial frenum, also known as a frenotomy, is 40806 (Incision of labial frenum (frenotomy)). When determining whether a code may be submitted more than once, you want to check the code’s medically unlikely edits (MUEs). An MUE is a unit of service claim edit that explains how many units of a given code a physician may submit for on one day...

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