Wiki MUE in Inpatient

[Swooshjoe3]

Do MUE's apply to inpatient setting (POS 21)? thanks for any help!

 

[mray85]

Yes. MUE edits apply in any place of service.

 

[amessmer1067]

Yes. MUE edits apply in any place of service.

Would you have any resources supporting this? Thank you!

 

[sls314]

Would you have any resources supporting this? Thank you!

That person was incorrect. MUE applies to Part B claims. You can refer to the CMS NCCI MUE page for the reference and note that the table specifically says "Outpatient Hospital Services MUE."

https://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits/medicare-ncci-medically-unlikely-edits

Inpatient UB-04 claims don't generally itemize units of individual codes - the codes are rolled up in aggregate by revenue code.

Edit to add: I replied in more detail on your inpatient auditing thread https://www.aapc.com/discuss/threads/inpatient-auditing-questions.195690/