Wiki Drug waste and MUEs

[tralbrecht]

I have drugs denying for exceeding the CMS MUEs. In certain instances, we are administering single dose vials. The waste exceeds the MUE. According to CMS, we are allowed to be reimbursed for waste. My question is, does the MUE include the waste, or can we exceed the MUE with waste, as long as the amount ACTUALLY administered is at or less than the MUE?

 

[rachaelwilleford]

MUE includes total billed units, but some MUEs can be appealed (which doesn't always mean that they will be paid, but that the MUE edit can be overriden in some situations). It depends on the CPT and the edit indicator.