CIGNA – Policy Updates May 2021

Frequency 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

Source: https://static.cigna.com/assets/chcp/resourceLibrary/coveragePolicies/policyUpdates/coveragePoliciesLatestUpdatesMay2021.html