HCPro, JustCoding Outpatient - 2017 Issue 9 (February)

Making sense of MUEs and MAIs

February 28th, 2017

The intersection of CMS’ packaged payment policy and the increasing volume of Medically Unlikely Edits (MUE) can be likened to a car crash waiting to happen. Hospitals are having valid, medically necessary claim lines denied – including charges and units below MUE limits. Providers can help stop the crash by ensuring their claims, CPT coding, medical necessity, and the units are all correct.

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