AMA CPT® Assistant - 2006 Issue 12 (December)

Medically Unlikely Edits (MUEs) (December 2006)

December 2006 page 15 Medically Unlikely Edits (MUEs) Question I have been hearing about a new set of CMS edits called MUEs? What are they and when will they be implemented? AMA Comment The Centers for Medicare and Medicaid Services (CMS) will be implementing a new program of edits on January 1, 2007. The Medically Unlikely Edits (MUEs), previously known as the Medically Unbelievable Edits, are units of service edits that reflect the maximum number of units of service that a provider might report for the same HCPCS/CPT code for the same beneficiary on the same date of service...

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CPT® Assistant content is the official source for CPT® coding guidance. It is an instrumental tool when appealing insurance denials and validating coding to auditors. Monthly issues and an extensive archive provide comprehensive guidance on proper CPT® coding for past, present and upcoming code set releases. Archives date back to 1990 for historical use of codes, changes, rationales, coding tips and trends in the industry.

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