tci General Surgery Coding Alert - 2024 Issue Q2

You Be the Coder: Refresh Your Understanding of MUEs

Question: Could you please clarify what “MUE” means and explain how it impacts my coding? Colorado Subscriber Answer: MUE is an acronym for medically unlikely edits, which the Centers for Medicare and Medicaid Services (CMS) established as a unit-of-service edit for Healthcare Common Procedure Coding System (HCPCS) Level II/Current Procedural Terminology (CPT®) codes. An MUE is assigned to a specific code to represent the maximum number of units of the code that you should report — either on a specific claim or on a specific date. CMS developed the edits to reduce the paid claims error rate...

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