General Question for the Week of February 12, 2018

General Compliance Question of the Week

Question:

How do I request a change in the MUE value for a CPT® code?

Answer:

If a provider/supplier, healthcare organization, or other interested party believes that a medically unlikely edit (MUE) value should be modified, it may write or fax to the following address:

National Correct Coding Initiative
Correct Coding Solutions, LLC
P.O. Box 907
Carmel, IN 46082-0907
FAX: 317-571-1745

You should include an alternative MUE value, the rationale for the recommended value, and any supporting documentation.

However, the Centers for Medicare & Medicaid Services (CMS) recommend that the national healthcare organization whose members perform the procedure be contacted first. The organization may be able to clarify the reporting of the code in question. If it agrees that the MUE value should be modified, its support and assistance may be helpful in requesting the modification of an MUE value.


CPT® is a registered trademark of the American Medical Association.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.