Health Information Management

Pay-per-view: CMS changing MUEs

APCs Insider, April 5, 2013

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CMS is making a significant change to the Medically Unlikely Edits (MUE) by changing some of them from line-item edits to date-of-service (DOS) edits, effective April 1.

An MUE represents the maximum units of service providers would typically report for a specific HCPCS or CPT® code and is based on several factors, including anatomy, code description, the agency's own policies, and the overall nature of a service. The MUEs apply for the same provider, the same patient, and the same DOS.
 
Continue reading CMS changing MUEs on HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the April issue.



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