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.
For more information on CCI Edits and MUEs or on Appeals please refer to DaisyBill’s Correct Coding Initiative and Reasons to File a Request for Second Review articles.
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