CMS Publishes Denials Criteria

The Centers for Medicare & Medicaid Services (CMS) announced
that beginning October 1, 2008, it will publish most of the
criteria for which it makes denials for excessive units of service
on claims. These criteria, called “edits,” are used by
claims-processing contractors who apply its Medically Unlikely Edit
(MUE) program during the electronic processing of all claims. CMS
has stated that it is publishing them to improve the accuracy of
claims payments.