CCI Edits and MUEs DO NOT APPLY to the Outpatient/ASC Fee Schedule.
DaisyBill reached out to the Department of Industrial Relations (DIR) specifically to clarify this. A DIR representative confirmed that the DIR “ha[s] not adopted CCI Edits for Outpatient / ASC fee schedule facility billing.”
Some bill review companies cite CCI edits or MUE’s to reduce payments for outpatient or ASC bills. This is a mistake and providers should seek proper reimbursement via Second Review.
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