BILLING NEWS

Medically Unlikely Edits

Effective January 01, 2007 Medicare contractors will implement CCI edits that will contain a new update for Medically Unlikely Edits (MUEs). MUEs represent limits on the units of service that a healthcare provider can bill a particular CPT/HCPCS code per Medicare beneficiary per day. Claims exceeding these limits will be automatically denied. Lab and Pathology codes in the CPT 80000 series will not be included in this release, with the exception of HCPCS “G” codes for PAP Smear and Prostate Cancer screening.


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INDUSTRY NEWS TAGS: CMS


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