Medically unlikely edits (MUEs), formally known as medically unbelievable edits, took effect with the Centers for Medicare & Medicaid Services (CMS) on January 2, 2007. The function of MUEs is to detect and deny unlikely CMS claims on a pre-payment basis with the intention of improving Medicare’s payment process.
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Coding Corner Question: January 2008
January’s Coding Challenge
Rehabilitation and Myositis
Physical therapy to manage inflammatory muscle disease
Science from our Sisters
Recommended reading from A&R and AC&R
Joint Surgery
Modern joint replacement surgery involves removal of worn cartilage from both sides of the joint, followed by resurfacing of the joint with a metal and plastic replacement implant that looks and functions much like a normal joint. Although nearly every joint in the body can be replaced, most replacement surgeries involve the hip or knee. Joint replacement surgery is typically recommended for patients who have tried non-surgical treatment but still have joint pain. While this is an extremely effective surgical treatment, total joint replacement should be considered as the last (rather than the first) treatment option for patients with advanced arthritis of the hip, knee, or shoulder.
Coding Corner Question
October’s coding challenge
Coding Corner Answer
October’s coding answer
Coding Corner Question
September’s coding challenge
Coding Corner Answer
September’s coding answer
Mayo and Grady CONNect
A journey from physician’s mecca to public hospital