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Medicare Publishes Medically Unlikely Edits
October 2008
CMS announced that effective October 1, 2008 most of the medically unlikely
edits (MUEs) will be published. A MUE is the maximum number of units of service
that a provider would report under most conditions for a patient on a
particular date of service.
Initially the edits were developed to reduce the claims error rate for Part B
claims. Until now these edits were not published for providers.
CMS utilizes these edits to assure that providers do not report excessive
services. The edits are applied during the processing of a claim.
The edits are listed on the CMS website at:
http://www.cms.hhs.gov/NationalCorrectCodInitEd/08_MUE.asp#TopOfPage
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