dballard2004
True Blue
Effective December 21, 2023, Cigna is implementing through ClaimsXten a Medically Unlikely Edit (MUE) for COVID-19 laboratory services for CPT codes 86328, 86408, 86409, 86413, 86769, 87426, 87428, 87635, 87636, 87637, 87811, 87913, 0202U, 0223U, 0224U, 0225U, 0226U, 0240U, 0241U and HCPCS codes U0001 and U0002 for provider services submitted on a CMS 1500 claim form and for outpatient facility services submitted on a UB-04 claim form. 
The MUE rules apply frequency limitations defined by the Centers for Medicare and Medicaid Services (CMS). CMS developed these edits based on anatomic considerations,HCPCS or CPT code descriptors, CPT instructions, CMS policies, nature of service or procedure, nature of the analyte, nature of the equipment, and clinical judgment.
For more information about Cigna's Coding Editing Policy and Guidelines, please refer to the attached document.
The MUE rules apply frequency limitations defined by the Centers for Medicare and Medicaid Services (CMS). CMS developed these edits based on anatomic considerations,
HCPCS or CPT code descriptors, CPT instructions, CMS policies, nature of service or procedure, nature of the analyte, nature of the equipment, and clinical judgment.For more information about Cigna's Coding Editing Policy and Guidelines, please refer to the attached document.