Check out 4 MUE Facts That Will Help You Avoid Denials - AAPC The MUE table includes a column for “MUE Adjudication Indicator” (MAI), which provides guidance about what circumstances allow you to override an MUE limit for a given code If the code has an MAI of “1,” the code is adjudicated on a claim-line basis, meaning that you can’t exceed the number of MUE units on a claim line
Don’t Chase Your Tail Over Medically Unlikely Edits - AAPC Avoid payer denials by ensuring your provider or supplier follows the rules for allowable MUE units Understanding why Medically Unlikely Edits (MUEs) were established, how they are organized, and the criteria on which edit rationales are based may help medical coders and billers avoid denials or, at a minimum, properly resolve a denial What Are MUEs? The Centers for Medicare Medicaid
Check MUEs to Avoid Unit Errors on Your Claim - AAPC As the figure below shows, the Medicare tool also includes the MAI (MUE Adjudication Indicator) next to the MUE Click the MAI for a definition explaining whether (and how) Medicare allows you to exceed the MUE Bonus: Also look for MUEs on code details pages, listing (range) pages, the CMS-1500 scrubber, and in the Part B fees tool
Learn MUE Limits and Options : You Be the Coder - AAPC Alert: The MUE table includes a column for “MUE Adjudication Indicator” (MAI), which provides guidance about what circumstances allow you to override an MUE limit for a given code If the code has an MAI of “1,” the code is adjudicated on a claim-line basis, meaning that you can’t exceed the number of MUE units on a claim line
Confused About MUEs? Consider These 4 Facts : Coding Edits - AAPC Fact 1: MUE Edits Limit Frequency Any practice filing a claim with Medicare should know what MUEs are and how they work, because these coding edits limit the frequency a CPT® code can be used Understanding MUEs allows you to better pinpoint when a claim is denied due to these edits versus those claims that should have been paid
Understand Meaning of MUE : Reader Questions - AAPC Specifically, CMS says: “An MUE is a unit of service edit for a Healthcare Common Procedure Coding System (HCPCS) Current Procedural Terminology (CPT®) code for services rendered by a single provider supplier to a single beneficiary on the same date of service
Overcome MUE Denial Challenges By Busting 4 Common Myths - AAPC Note: While CMS updates the MUE list every quarter, just like the Correct Coding Initiative (CCI) edits, it does not publish all MUEs The published MUE list consists of most of the codes with MUE values of 1-3, but CMS does not publish all MUE values that are 4 or higher You can find the published edits on the CMS Web site
Reimbursement Policy Medically Unlikely Edits (MUE) - AAPC UnitedHealthcare Medicare and Retirement expanded the MUE program to include HCPCS “J” codes The “J” code edits were developed based on HCPCS code descriptors, an unpublished CMS “J” code MUE list, a UnitedHealthcare published MUE list, historical claim data, condition dosage requirements and clinical judgment UnitedHealthcare Medicare and Retirement will continue to refine the