The Centers for Medicare & Medicaid Services (CMS) yesterday announced that, beginning Oct. 1, 2008, it will publish most of the edits used in its Medically Unlikely Edit (MUE) program to improve the accuracy of claims payments. The Oct. 1, 2008, version of MUE was to contain edits for about 9,700 HCPCS/CPT codes that have been assigned unit values for MUEs. The edits are published on the CMS web site.
CMS established the MUE program to reduce payment errors for Medicare Part B claims. Claims processing contractors use these edits to ensure that providers and suppliers do not report excessive services; the edits are applied during the electronic processing of all claims. Studies have identified significant Medicare overpayments because provider or supplier claims sometimes report services with too many units of service. These errors may be caused by numerous factors, including clerical or coding errors. Read the press release.
