Can we bill a patient for a service that denied due to MUE? Should we issue an Advance Beneficiary Notice (ABN) to the patient in this case?

Answer
No, a patient is not liable for a service that was denied for MUE. A denial of services due to an MUE is a coding denial, not a medical necessity denial. Therefore, the presence of an ABN does not shift liability to the beneficiary and ABN issuance based on an MUE is not appropriate.  

Resource: MLN Article MM8853 - Revised Modification to the Medically Unlikely Edit (MUE) Program (PDF, 99 KB)

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