tci Medicare Compliance & Reimbursement - 2008 Issue 33

Medical Edits: CMS Finally Publishes Long-Awaited List of Medically Unnecessary Edits

Look to MUE list to find out how many units of any particular code your carrier will reimburse. CMS has reversed a decision, and for once, that's a good thing. Despite the agency's insistence that it would not publish its list of medically-unlikely edits (MUEs), CMS changed course, and published the listing on Oct. 1. The MUE program aims to help CMS "dramatically reduce costly payment errors," said CMS Acting Administrator Kerry Weems in an Oct. 1 statement. However, the news release acknowledges that "CMS has not yet determined if there have been any savings in the MUE ...

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