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Ophthalmology and Optometry Coding Alert

Denials Management:

Bust 4 Common Myths to Overcome MUE Denial Challenges

Published on Fri Apr 01, 2011

Ignore medically unlikely edits at your peril for claim rejection.Are you seeing more denials from Medicare for your ophthalmological services? You could be running up against medically unlikely edits (MUEs). Designed to prevent overpayments caused by gross billing errors (usually a result of clerical or billing systems' mistakes), MUEs often confuse even veteran coders. Ensure you're not letting MUEs wreak havoc on your ophthalmology practice's coding and reimbursement by uncovering the truth about four aspects of these edits.Myth 1: MUE Edits Don't Affect Your PracticeSome practices feel that they don't need to worry about MUEs.Reality: Any practice filing a claim with Medicare should know what MUEs are and how they work. "They limit the frequency a CPT code can be used," says Chandra L. Hines, business office manager at a practice in Raleigh, N.C. "We need to become aware of the denials and not let every denial go because the [...]
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