Practice Management Alert

If you ignore the medically unlikely edits, you're asking for a claim rejection.If you're receiving denials from Medicare, one possibility is that you're running up against medically unlikely edits (MUEs). The edits, which are designed to prevent overpayments caused by gross billing errors, usually a result of clerical or billing systems' mistakes, often confuse even veteran coders.Ensure you're not letting MUEs wreak havoc on your 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: While you shouldn't stress too much, 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 [...]