If you have a SuperCoder package that includes the Medicare Physician Fee Schedule (MPFS), then you know that the tool includes Medicare Medically Unlikely Edits (MUEs). Well now you have more, even faster ways to find MUEs, and you get Medicaid MUEs, too!
On your Coding Tools or Coder main page, select Medically Unlikely Edits from the left menu. Then choose MCR MUE for Medicare MUEs or MCD MUE for Medicaid MUEs. A new page will open with the tool, where you can enter the code and select the year and quarter to find the MUE for your date of service.
On code details pages, watch for the Medically Unlikely Edits tab in the Compliance Tools box. You’ll see both Medicare and Medicaid MUEs for your selected code, featuring current quarter data. Code range pages also have a Medically Unlikely Edits button with each code so you can see current Medicare and Medicaid MUEs in a convenient pop-up box.
How do MUEs help you? MUEs let you know the maximum number of units a payer expects to see on your claim for a particular CPT® or HCPCS code. Exceeding that number of units can trigger denials, so easy access to MUEs simplifies the work of denial prevention and lets you know what to expect for your claims!