April 17, 2015
Modifications to Medicare’s MUE Program
The Centers for Medicare and Medicaid Services (CMS) have long been looking for ways to save the Medicare program money and to reduce paid claim error rates. CMS implemented the National Correct Coding Initiative (NCCI) procedure-to-procedure claims edits in 1996. In 2007, CMS added another type of claims edit under NCCI – Medically Unlikely Edits (MUE) and in April of 2013, CMS modified the MUE program so that some MUE values would be date of service edits rather than just claim line edits. Read this ASA Timely Topic article to expand your knowledge of MUE edits and how they impact your claim submissions.