DecisionHealth, DecisionHealth - 2010 Issue 4 (April)
Get money back with new CMS rule allowing MUE appeals
You can now appeal denials resulting from medically unlikely edits (MUEs), which gives you the ability to fight for payments when you can prove that exceeding the edit limit was medically necessary, experts say. CMS reversed previous policy on MUE appeals in Transmittal 652, which took effect April 1. Remember: MUEs are simple edits that only look at units of service performed on the same patient, on the same day, by the same provider.
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