Medicare publishes billing edits to reduce payment errors

The Centers for Medicare & Medicaid Services (CMS) recently announced its decision to publish most of the edits utilized in its Medically Unlikely Edit (MUE) program in order to improve accuracy of claims payments. The MUE program—implemented Jan. 1, 2007, and updated quarterly—was established to reduce payment errors for Medicare Part B claims. The latest program update, revealed Oct. 1, contains edits for about 9,700 Healthcare Common Procedure Coding System (HCPCS)/Current Procedural Terminology (CPT®) codes that have been assigned unit values for MUEs. Claims processing contractors utilize these edits to ensure that providers and suppliers do not report excessive services. MUEs were developed by CMS with the cooperation and participation of national health care organizations representing physicians, hospitals, nonphysician practitioners, laboratories and durable medical equipment suppliers. To learn more and view these edits go to http://www.cms.hhs.gov/NationalCorrectCodInitEd/08_MUE.asp#TopOfPage  CMS will publish an update of most MUEs at the start of each calendar quarter.