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  • Angel Callaway, CPC, CPB

MUE'S (Medically Unlikely Edits)

MUE's indicate the number of allowed units per day/service/claim that can be paid on a service. The edit means it is unlikely but more units may be payable depending on the particular circumstance.



When attempting to get paid for units over the MUE allowed the documentation must be clear as to why the additional units are needed. You will need to always appeal when submitting for units over the allowed MUE. It is a good ideal when possible to submit the documentation and a cover letter, explaining the reasoning for the medical records, with the claim so a review can be done prior to the claims final adjudication.





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MUE's indicate the number of allowed units per day/service/claim that can be paid on a service. The edit means it is unlikely but more units may be payable depending on the particular circumstance. When attempting to get paid for units over the MUE allowed the documentation must be clear as to why the additional units are needed. You wil need to always appeal when submitting for units over the allowed MUE. It is a good ideal when possible to submit the documentation and a cover letter, explaining the reasoning for the medical records, with the claim so a review can be done prior to the claims final adjudication.


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