Medically Unlikely Edits

Medically Unlikely Edits (MUEs) is a tool used by the Centers for Medicare and Medicaid Services (CMS) to identify and prevent potential overuse of certain procedures or services that are unlikely to be medically necessary. These edits are based on historical claims data and are intended to ensure that healthcare providers are not billing for unnecessary services. MUEs are applied to specific codes, such as Current Procedural Terminology (CPT) codes, and limit the number of units that can be billed for a specific service in a single day.

1. There are a few places you can find MUEs (Medically Unlikely Edits)

2. Under the 'Coding Tools' Tab, click on MCR or MCD MUE           
 

3. Enter your CPT or HCPCS code, select the year and the quarter, and click 'Calculate'           
 

4. You can also see the MUEs when you use the Fee Schedules tool under the 'Coding Tools' Tab            


 

5. You can also find the MUEs on the code details page under the 'Compliance Tools'            
 

The MUEs are available with  Basic Coder, Pro Fee, and Complete Coder subscriptions