Get the free MUE (Medically Unlikely Edits), or units-of-service detail edits
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Wisconsin MedicaidClaims1Family Planning Only ServicesPublished Policy Through January 31, 2022Page 1 of 100Wisconsin MedicaidArchive Date:02/01/2022Claims:Good Faith Claims
Topic #518Definition of
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How to fill out mue medically unlikely edits
How to fill out mue medically unlikely edits
01
Review the list of MUE codes provided by the CMS.
02
Identify the codes in the claim that exceed the MUE limit.
03
Determine if the excess units are appropriate based on the patient's medical condition and documentation.
04
If the excess units are not supported, adjust the claim to match the MUE limit.
05
Submit the corrected claim for processing.
Who needs mue medically unlikely edits?
01
Healthcare providers who submit claims for services that may exceed the MUE limits set by CMS.
02
Medical coders and billers who are responsible for ensuring claims are accurate and compliant.
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What is mue medically unlikely edits?
MUE medically unlikely edits are units of service that should not occur in a healthy individual.
Who is required to file mue medically unlikely edits?
Healthcare providers and facilities are required to file MUE medically unlikely edits.
How to fill out mue medically unlikely edits?
MUE medically unlikely edits can be filled out using the specific forms provided by the relevant healthcare organization or payer.
What is the purpose of mue medically unlikely edits?
The purpose of MUE medically unlikely edits is to prevent unnecessary or excessive medical services.
What information must be reported on mue medically unlikely edits?
MUE medically unlikely edits must include details of the service provided, the patient's information, and the reason for the service.
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