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What does a MUE of 1 mean?

What does a MUE of 1 mean?

1. An MUE Adjudication Indicator (MAI) of “1” indicates that the edit is a claim line MUE. a. Appropriate use of NCCI modifiers (e.g., 59, 76, 77, 91, anatomic) may be used to report the same HCPCS/CPT code on separate lines of a claim.

How do I check my MUE edits?

Enter the CPT/HCPCS code. Click Search. If CMS has a published MUE for the CPT/HCPCS code, the following will display: Effective date of the quarterly edits selected….The MAI provides the rationale for the edit.

  1. MAI 1: Claim Line Edit.
  2. MAI 2: Absolute Date of Service Edit.
  3. MAI 3: Date of Service Edit.

Can MUE edits be overridden?

Many of the appeals filed for MUE denials denied due to an MUE Adjudication Indicator (MAI) 2 edit. MAI 2 is an absolute date-of-service limit that can’t be overridden or bypassed with a modifier. Since MAI 2 is a date-of-service edit and is absolute (will never change), these denials cannot be appealed.

What is MUE in coding?

An MUE for a HCPCS/CPT code is the maximum units of service that a provider would report under most circumstances for a single beneficiary on a single date of service. Not all HCPCS/CPT codes have an MUE.

Are there limits to the number of MUE edits?

MUE edit limits with an MUE Adjudication Indicator of “3” (Date of Service Edit: Clinical): a. It would be possible but medically highly unlikely that more units than the MUE value would ever be performed on the same date of service for the same patient.

What does CMS Mue quantity limit exceeded mean?

What does CMS Mue quantity limit exceeded mean? An MUE for a HCPCS code is the maximum units of service that a provider would bill under most circumstances for a single beneficiary on a single date of service. These edits are set to deny claim lines exceeding the acceptable maximums.

What does Mue stand for in HCPCS code?

An MUE for a HCPCS code is the maximum units of service that a provider would bill under most circumstances for a single beneficiary on a single date of service. These edits are set to deny claim lines exceeding the acceptable maximums.

What does a Mue value of 0 mean?

A Publication Indicator of “0” indicates that the MUE value for that code is. confidential, is not in the CMS official publication of the MUE values, and should not be shared with. providers/suppliers or other parties outside the CMS contractor’s organization. Beside this, what does Mue of 2 mean?