tci Medicare Compliance & Reimbursement - 2006 Issue 21

CODING: Believe It Or Not, You May Be Able To Bill For Unlikely Services

Watch out for MUE proposed in August.Good news: You may not have another smothering layer of edits coming down on your claims in January after all.The Centers for Medicare & Medicaid Services (CMS) had planned to impose medically unbelievable edits (MUEs) on every single code starting in January 2007. These edits would have focused on cases where you billed for too many units of a particular code, or performed a procedure twice when it should only happen once. Many physicians complained that the MUEs would have made it impossible to bill for situations where a patient needed...

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