tci Part B Insider - 2022 Issue Q1

Reimbursement: Sidestep Denials With 4 MUE Facts

Boost Medicare claims with medically unlikely edit know-how. If your Part B practice keeps getting hit with denials from your MAC for undetermined reasons, the culprit may be confusion over medically unlikely edits (MUEs). The edits, which are designed to prevent overpayments caused by serious billing errors, often confound even the most seasoned coders. Ensure you’re not letting MUEs wreak havoc on your practice’s coding and reimbursement by uncovering the truth about four aspects of these edits. Fact 1: MUE Edits Limit Frequency Any practice filing a claim with Medicare should know what MUEs are and how...

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