Health Information Management

Medically unlikely edits remain a puzzle to providers

Briefings on APCs, June 1, 2008

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Earlier this year, CMS advised that the medically unlikely edit (MUE) value for units with CPT infusion codes 90766 or 90761, billed to FIs, would be increased on April 1, retroactive to the original date of January 1. However, not until the end of April did providers begin to notice infusion and injection claims being accepted for values that had previously been rejected, whereas reports of other MUEs appeared in the April Open Door Forum (ODF).

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