Medicare Medically Unlikely Edits

The CMS developed Medically Unlikely Edits (MUEs) to reduce the paid claims error rate for Part B claims.  An MUE for a HCPCS/CPT code is the maximum units of service that a provider would report under most circumstances for a single beneficiary on a single date...

Hospital Outpatient PPS and Therapy NCCI

The CCI edits are part of the Outpatient Code Editor (OCE) that edits all outpatient claims and assigns APCs for Outpatient PPS services.  In the past, the Outpatient Code Editor (OCE) did not include CCI edits for the following: anesthesiology, evaluation, and...

Medicare NCCI edit and correct coding policy

National Correct Coding Initiatives Edits The CMS developed the National Correct Coding Initiative (NCCI) to promote national correct coding methodologies and to control improper coding leading to inappropriate payment in Part B claims. The CMS developed its coding...