Table of Contents
What does an MUE value of 0 mean?
A Publication Indicator of “0” indicates that the MUE value for that code is. confidential, is not in the CMS official publication of the MUE values, and should not be shared with. providers/suppliers or other parties outside the CMS contractor’s organization.
What does MUE value of 1 mean?
1) Anatomic considerations may limit units of service based on anatomic structures. For example, the MUE value for an appendectomy is “1” since there is only one appendix.
What is the MUE limit?
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 of service.
What does a 0 in an NCCI edit mean?
can never be bypassed
A modifier indicator of “0” indicates that an edit can never be bypassed even if a modifier is used. In other words, the Column 2 code of the edit will be denied.
What does MUE of 2 mean?
Q. What does an MUE Adjudication Indicator (MAI) mean? The MUE files on the CMS NCCI website display an MAI for each HCPCS/CPT code. An MAI of “1” indicates that the edit is a claim line edit. An MAI of “2” or “3” indicates that the edit is a date of service MUE.
What is the modifier 0 1 and 9 indicator?
In the modifier indicator column, the indicator 0, 1, or 9 shows whether an PTP-associated modifier allows the PTP code pair to bypass the edit.
What does 0 mean on NCCI edits?
A modifier indicator of “0” indicates that an edit can never be bypassed even if a modifier is used. In other words, the Column 2 code of the edit will be denied. A modifier indicator of “1” indicates that an edit may be bypassed with an appropriate modifier appended to the Column 1 and/or Column 2 code.
What is MUE adjudication indicator?
MUE Adjudication Indicator (MAI): Describes the type of. MAI 1: Applied at line level (claim line) – Appropriate use of modifiers to report the same code on separate lines of a claim will enable the reporting of medically necessary units of service in excess of MUE.