Name of Manual - Blue Cross and Blue Shield of Minnesota

Units of Service
Validation and
Restriction
Blue Cross Blue and Shield of Minnesota Provider Policy and Procedure Manual (07/12/12)
Coding Policies and Guidelines (Coding)
Blue Cross edits procedure code units on professional claims
(837P/1500 HICF).
While each service must be submitted with a unit of measurement,
multiple units of service per code, per date of service are only
applicable if the code definition supports submission of more than
one unit. This is usually indicated by words such as each or per.
Additionally, the number of units for codes that qualify for
submission of multiple units may be subject to limits. Although
Blue Cross is not following Medicare’s Medically Unlikely Edits
(MUE), the editing logic is similar to MUEs.
This edit will occur in the pre-adjudication phase of processing. If
the claim submission does not pass (or fails for greater than one
unit per day) it will stop and be rejected back to the provider.
This rejection occurs before the submission is accepted as a claim,
therefore a claim number is not assigned and the provider must
correct the data and resubmit all charges. There will not be any
duplicate editing or adjustments because a “claim” was not created
in the payer adjudication system.
The error denial message will be:
2045 -- Unit(s) billed is inconsistent with procedure code.
Please correct the claim and resubmit.
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