Corporate Compliance

Transmittals and MLN Matters articles: CMS posts MUE instructions

Medicare Insider, August 16, 2011

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CMS issues MUE guidance

On August 12, CMS issued a transmittal to give instructions regarding the medically unlikely edits (MUE). In the business requirements of the transmittal, CMS instructed shared systems maintainers to allow a value of “0” units to be assigned to an MUE. CMS is making this change to account for 25 codes that have been discontinued plus any codes for services that Medicare does not cover or discontinues coverage. CMS also provides further clarification and explanation of the MUEs in this transmittal.

Effective date: The effective date for MCS is January 1, 2012, and the effective date for VMS is April 1, 2012. FISS has already met the requirements for this CR.
Implementation date: The implementation date for MCS is January 3, 2012, and the implementation date for VMS is April 2, 2012. FISS has already met the requirements for this CR.

View the transmittal.



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