Health Information Management

Now on the to-track list: medically unlike edit appeals

Briefings on APCs, May 1, 2010

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An MUE for a HCPCS/CPT code is triggered by the maximum units of service that a provider would report under most circumstances for a single beneficiary on a single date of service. Not all HCPCS/CPT codes have an MUE.

CMS will now deny claim lines with units of service in excess of the MUE for that code. Previously, it either rejected these lines or returned to the provider.
 

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