Medicare Publishes Billing Edits to Reduce Payment Errors

October 10, 2008 – Beginning October 1, 2008, the Centers for Medicare and Medicaid Services (CMS) will publish edits utilized in its Medically Unlikely Edit (MUE) program, which aims to decrease the paid error rate for Medicare Part B claims. The edits, which are applied during the electronic processing of claims, place limits on the number of times a service can be billed by a single provider to a single beneficiary on the same date of service. CMS first implemented the MUE program January 1, 2007, with edits for about 2,600 HCPCS/CPT codes. Through a quarterly update process, additional codes have been added. Although CMS will publish most MUE values on its Web site, some MUE values are confidential and are for CMS and CMS Contractors' use only. The publicly available edits can be found on the CMS Web site.