tci General Surgery Coding Alert - 2005 Issue 5

Medicare Proposes, Rescinds 'Medically Unbelievable' Edits

If you've heard rumors of a new category of coding edits, you can take a deep breath and relax. Medicare has halted, at least temporarily, its plans to develop so-called "medically unbelievable" edits (MUEs) for inclusion in the National Correct Coding Initiative (NCCI).The Centers for Medicare and Medicaid Services announced in Transmittal 105 (Feb. 18, 2005) that it had hired AdminaStar Federal to develop MUEs to target multiple claims for particular services made for one patient on the same day.Carriers have had frequency edits in place for years, says consultant Quinten Buechner, MS, MDiv, CPC, president of...

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