Health Information Management

Pay-per-view: Understanding the value of MUEs

APCs Insider, March 7, 2014

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When an NCCI edit occurs on a claim, providers can go directly to CMS’ website and download the latest edits to pinpoint why the edit occurred and what codes may be conflicting.
However, when encountering a medically unlikely edit (MUE), they may not be able to tell exactly why the edit occurred, as MUEs are not uniformly posted by CMS.
“These are usually built into your coding and billing systems, and they’re going to pop up as edits,” said Debbie Mackaman, RHIA, CPCO, regulatory specialist for HCPro in Danvers, Mass., during the recent audio conference “NCCI Edits and Modifiers: Ensure Compliant Claims.” “Unfortunately, the bad news is that not all of the values are published.”
Continue reading Understanding the value of MUEs on HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the February issue.

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