Health Information Management

Healthcare News: CMS issues revised transmittal addressing MUEs

JustCoding News: Inpatient, January 20, 2010

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CMS issued Transmittal 617 in the One-Time Notification Manual on January 8 to rescind and replace Transmittal 178, Change Request 5402 on medically unlikely edits (MUE). Among the changes included in Transmittal 617 are updates on how CMS will process claims containing modifier -55 (Postoperative management only).

The Transmittal states:
Contractors may process claim service lines that exceed MUE limits and also contain a -55 modifier in a manner such that the MUE audit will not systematically deny the service line.

To learn more about this and other changes, access Transmittal 617.



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