Dataset Identification:
Resource Abstract:
- description: <p>Medically Unlikely Edits (MUEs) define for each HCPCS / CPT code the maximum units of service (UOS)
that a provider would report under most circumstances for a single beneficiary on a single date of service.</p> <p>Practitioner
services also refers to ambulatory surgical centers.<br /> DME refers to provider claims for durable medical equipment.</p>
<p>The CMS National Correct Coding Initiative (NCCI) promotes national correct coding methodologies and reduces improper
coding which may result in inappropriate payments of Medicare Part B claims and Medicaid claims. NCCI procedure-to-procedure
(PTP) edits define pairs of Healthcare Common Procedure Coding System (HCPCS)/Current Procedural Terminology (CPT) codes that
should not be reported together for a variety of reasons. The purpose of the PTP edits is to prevent improper payments when
incorrect code combinations are reported. The edits in this dataset are active for the dates indicated within. This file should
NOT be used by state Medicaid programs as their edit file. Current Procedural Terminology (CPT) codes, descriptions and other
data only are copyright 2017 American Medical Association. All rights reserved. CPT is a registered trademark of the American
Medical Association. Applicable FARSDFARS Restrictions Apply to Government Use. Fee schedules, relative value units, conversion
factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their
use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability
for the data contained or not contained herein.</p> <p>For more information, visit <a href="https://www.medicaid.gov/medicaid/program-integrity/ncci/index.html">https://www.medicaid.gov/medicaid/program-integrity/ncci/index.html</a>.</p>;
abstract: <p>Medically Unlikely Edits (MUEs) define for each HCPCS / CPT code the maximum units of service (UOS) that
a provider would report under most circumstances for a single beneficiary on a single date of service.</p> <p>Practitioner
services also refers to ambulatory surgical centers.<br /> DME refers to provider claims for durable medical equipment.</p>
<p>The CMS National Correct Coding Initiative (NCCI) promotes national correct coding methodologies and reduces improper
coding which may result in inappropriate payments of Medicare Part B claims and Medicaid claims. NCCI procedure-to-procedure
(PTP) edits define pairs of Healthcare Common Procedure Coding System (HCPCS)/Current Procedural Terminology (CPT) codes that
should not be reported together for a variety of reasons. The purpose of the PTP edits is to prevent improper payments when
incorrect code combinations are reported. The edits in this dataset are active for the dates indicated within. This file should
NOT be used by state Medicaid programs as their edit file. Current Procedural Terminology (CPT) codes, descriptions and other
data only are copyright 2017 American Medical Association. All rights reserved. CPT is a registered trademark of the American
Medical Association. Applicable FARSDFARS Restrictions Apply to Government Use. Fee schedules, relative value units, conversion
factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their
use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability
for the data contained or not contained herein.</p> <p>For more information, visit <a href="https://www.medicaid.gov/medicaid/program-integrity/ncci/index.html">https://www.medicaid.gov/medicaid/program-integrity/ncci/index.html</a>.</p>
Citation
- Title NCCI Medically Unlikely Edits (MUEs).
-
- creation Date
2018-06-08T21:30:22.725628
Resource language:
Processing environment:
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Metadata data stamp:
2018-08-06T19:35:43Z
Resource Maintenance Information
- maintenance or update frequency:
- notes: This metadata record was generated by an xslt transformation from a dc metadata record; Transform by Stephen M. Richard, based
on a transform by Damian Ulbricht. Run on 2018-08-06T19:35:43Z
Metadata contact
-
pointOfContact
- organisation Name
CINERGI Metadata catalog
-
- Contact information
-
-
- Address
-
- electronic Mail Address cinergi@sdsc.edu
Metadata language
eng
Metadata character set encoding:
utf8
Metadata standard for this record:
ISO 19139 Geographic Information - Metadata - Implementation Specification
standard version:
2007
Metadata record identifier:
urn:dciso:metadataabout:ff579356-8557-4f84-9a99-d17fcd61a115
Metadata record format is ISO19139 XML (MD_Metadata)