CIGNA – Policy Updates May 2021
June 3, 2021Frequency Editing – (R34)
- The Centers for Medicare & Medicaid Services (CMS) has assigned medically unlikely edit (MUE) limits to laboratory services billed with Current Procedural Terminology (CPT®) codes 83921, 86318, 86332, 86353, and 87798.
- We will deny any units exceeding the MUE limits for these codes, effective for claims processed on or after May 16, 2021.
- Modifiers will not be allowed to override MUE limits for these codes
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