Neurosurgery Coding Alert

Regulations would have enacted per-day limits on certain codes

If you've heard rumors of a new category of coding edits, you can take a deep breath and relax - at least for the immediate future.

Medicare has halted its plans to develop so-called "medically unbelievable" edits (MUEs) for inclusion in the National Correct Coding Initiative (NCCI).

The Centers for Medicare and Medicaid Services announced in Transmittal 105 (Feb. 18, 2005) that it had hired AdminaStar Federal to develop MUEs to target multiple claims for particular services made for one patient on the same day.

Carriers have had frequency edits in place for years, says consultant Quinten Buechner, MS, MDiv, CPC, president of ProActive Consultants in Cumberland, Wis. The MUEs, then - although adding complexity to the NCCI - may have helped to standardize practices among all payers.

But, only a few weeks after its initial announcement, CMS rescinded without explanation its plans to establish the MUEs.

A source within CMS confirmed, however, that the agency expects to reissue the MUEs, most likely with some modifications, at a later date. Keep reading Neurosurgery Coding Alert for more information as soon as it becomes available.