Reviewed Sep 20, 2026 · maintained by Erin Rose · general reference, not legal advice
What the remit says
CO-151 — “Payment adjusted because the payer deems the information submitted does not support this many/frequency of services.”
Usually with: N362 “The number of Days or Units of Service exceeds our acceptable maximum”.
Verbatim, X12 code lists 11/1/2025.
Why it lands on drug claims
Every HCPCS drug code has a billing unit that is not the vial and not the milligram you charted — J1756 is per 1 mg, J1439 per 1 mg, J0897 per 1 mg, J1745 per 10 mg. Bill a 100 mg infliximab dose as 100 units of J1745 and you have claimed 1,000 mg; the MUE returns CO-151. The units calculator on this site exists because of this line.
The MUE adjudication indicator decides what you can do about it. MAI 1 is a claim-line edit: split the dose across lines with the right modifiers and it can pay. MAI 2 is a date-of-service edit based on policy — more than that many units in a day is not payable, period. MAI 3 is a date-of-service edit based on clinical data: a higher dose is possible and appealable with records.
Administration codes have their own MUEs and they are small: one initial infusion per day, a handful of injections. A claim with two 96365 lines for two drugs trips CO-151 on the second one even before NCCI looks at it — the second drug is 96367, one unit.
MUE limits for the codes this denial usually lands on
| Code | Descriptor | Practitioner MUE | Facility MUE |
|---|---|---|---|
| J1756 | Iron sucrose injection (per 1 mg) | 500 | 500 |
| J0897 | Denosumab injection (per 1 mg) | 120 | 120 |
| J1439 | Inj ferric carboxymaltos 1mg (per 1 mg) | 1000 | 1000 |
| J1745 | Infliximab not biosimil 10mg (per 10 mg) | 150 | 150 |
| J3262 | Tocilizumab injection (per 1 mg) | 800 | 800 |
| 96365 | therapeutic IV infusion, initial hour | 1 | 2 |
| 96413 | chemo IV infusion, initial hour | 1 | 1 |
| 96372 | SC/IM injection | 4 | 5 |
| 96374 | IV push, single or initial | 1 | 1 |
Units per date of service, CMS NCCI MUE tables Q3 2026. Full lookup: MUE lookup.
The fix
- Recompute units from the documented dose and the code's billing unit before you touch the claim; the MUE table above shows the ceiling.
- If the units were wrong, correct them and resubmit (corrected claim). Do not appeal a math error.
- If the dose was right and the MUE is MAI 1 (claim-line), report the dose across lines that reflect reality — one line per vial or per date of service, with JW on any discarded units — and resubmit.
- If the dose was right and the MUE is MAI 3, appeal with the order, the weight-based calculation and the administration record.
What to attach
- The signed order with dose, weight and the calculation
- The administration record with vial NDCs and amounts given/discarded
- For biologics: the label dosing table showing the dose is within the approved range
Corrected claim or appeal?
Units math wrong: corrected claim, never an appeal. Dose right and the code is MAI 1: report the dose across lines that reflect the vials or dates and resubmit. Dose right and MAI 3: redetermination with the order, weight-based calculation and administration record.
Medicare windows (redetermination 120 days, reconsideration 180 days, ALJ 60 days) and the commercial path are on the denials hub, cited to 42 CFR Part 405 Subpart I; the edits are CMS's NCCI tables.
Frequently asked
- Is the MUE the maximum dose?
- No. It is the maximum units a payer will pay on one line or one date of service without more information. The MUE for J1756 is 500 units (500 mg) per day; the largest single dose on the iron sucrose label is 400 mg, so a claim above 500 is a units error, not a dosing question.
- Can I split the drug across two lines to get under the MUE?
- Only when the adjudication indicator is 1 (claim-line) and the split reflects reality — two vials, one with waste billed with JW. Splitting an MAI-2 or MAI-3 code across lines to get under a date-of-service edit is what the edit was built to catch.
- Does CO-151 apply to the administration code?
- Yes, and it is the more common trigger on hospital claims: 96365 has an MUE of 1 per day for practitioners and 2 for hospital outpatient departments. A second therapeutic infusion is 96367; a second hour is 96366. Two units of 96365 on a practitioner claim is a units denial.
Related references
Get the units right the first time
Claim Check converts the documented dose to billing units from the HCPCS descriptor and checks every line against the MUE table before submission.
Open Claim CheckSources & how this is maintained
- Computed on this page
- MUE limits, practitioner and facility, for five J-codes and four administration codes. Edits vintage Q3 2026.
- Authored
- The billing-unit conversion behind most CO-151s, the three adjudication indicators, and when a split is honest.
- Corrections
- Send one with the remit line.