Reason Code: 52MUE
Error Description:
All the line items on the claim have units of service that are in excess of the medically reasonable daily allowable frequency. The excess charges due to units of service greater than the maximum allowable may not be billed to the beneficiary and this provision can neither be waived nor subject to an ABN.
Avoiding/Correcting This Error
You have the right to submit an appeal when you believe the medical records support that the denied services were reasonable and medically necessary.
Providers should review the information on the CMS website for Medically Unlikely Edits prior to claim submission. If the units rendered are in excess of the allowed units for that service, consider whether the excess units were actually rendered and billed correctly.