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A medically unlikely edit (mue) is a us medicare unit of service claim edit applied to medical claims against a procedure code for medical services rendered by one provider/supplier to one patient on one day In addition to these programs, cms has other. Claim edits compare different values on medical claim to a set of defined criteria to check for irregularities, often in an automated claims processing system
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The centers for medicare & medicaid services (cms) is a federal agency within the united states department of health and human services (hhs) that administers the medicare program and works in partnership with state governments to administer medicaid, the children's health insurance program (chip), and health insurance portability standards
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