MUE update exhibits shocking values

Would you report 24 office visits for the same patient on the same day? What about a solid 24 hours of psychotherapy? You’ll be able to starting July 1, according to the medically unlikely edit (MUE) change file that CMS posted today.

 

The latest quarterly MUE change file includes 105 E/M and procedure codes that have been assigned an MUE of 24. That list is comprised of 42 E/M codes, including 99201-99215, more than two dozen behavioral health codes, and several physical therapy codes.

 

The codes listed as additions to the MUE list were deleted by the off-schedule update that CMS issued April 7, based on a quick comparison of the two lists. It’s likely that someone at the National Correct Coding Initiative’s (NCCI) contractor hit the wrong key when reinstating the edits. We sent CMS a question about the file and will update this blog when we learn more.