CMS to publish edits in its Medically Unlikely Edit (MUE) program
Recovery Auditor Report, October 4, 2008
Want to receive articles like this one in your inbox? Subscribe to Recovery Auditor Report!
Good news for those preparing for a RAC review: CMS is publishing most of the edits used in its Medically Unlikely Edit (MUE) program.
The regulators said in a press release yesterday the reason for publishing the edits – it began to do so yesterday – is “to improve the accuracy of claims payments.” MUEs are a major part of RACs.
Stacey Levitt, RN, MSN, CPC, the director of patient care management at Lenox Hill Hospital in New York City, NY, says the MUEs were a “significant focus” of her facility’s RAC reviews.
CMS established the MUE program January 1, 2007, to ensure providers and suppliers do not report excessive services on Medicare Part B claims. The material published yesterday will have edits for about 9,700 HCPCS/CPT codes.
The edits will be published on the CMS Web site here. To read the full press release from CMS, click here.
Want to receive articles like this one in your inbox? Subscribe to Recovery Auditor Report!
Comments
0 comments on “CMS to publish edits in its Medically Unlikely Edit (MUE) program ”
Related Products
-
Briefings on The Joint Commission
Briefings on The Joint Commission will help you with all of your accreditation and survey preparation needs. Every month...
-
The CMS Survey Coordinator's Handbook
There is no reason to struggle with CMS requirements. HCPro has teamed up with former contracted CMS surveyor Jeff Coleman...
-
The Medicare Part B Billing Manual for Long-Term Care
This 150-page book breaks down Part B billing into separate revenue streams and includes examples of how to fill out the...
-
The RUG-IV Conversion: Financial Implications for Your Facility
When RUG-IV takes effect on October 1-whether in part or in full-is your facility prepared for the financial and operational...
-
Medicare Audits in Long-Term Care: A Guide to MACs, RACs, and ZPICs
This book describes the different types of Medicare audits that nursing homes face and helps you take a proactive approach...
Most Popular
- Articles
-
- HIPAA Q&A: Answering service messages
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Q&A: Coding for dry skin due to cold weather
- Q/A: Volume requirement for reporting hydration services
- Are your workforce members texting PHI?
- Topic: CMS, OESS post new security compliance review information, checklist
- What does case-mix index mean to you?
- Privacy, security concerns high in HIEs
- QA:Coding multiple initial infusions
- OB services: Coding inside and outside of the package
- E-mailed
-
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Q/A: Volume requirement for reporting hydration services
- HIPAA Q&A: Level of encryption needed for email
- HIPAA Q&A: Answering service messages
- HIPAA Q&A: TPO disclosures to a business associate
- Are your workforce members texting PHI?
- Q&A: Coding for dry skin due to cold weather
- Hospitalist-surgeon comanagement has no effect on outcomes
- Don't let these sentinel events trigger falsely
- Correctly bill ancillary bedside procedures in addition to the room rate
- Searched