NCCI edits, such as Medically Unlikely Edits (MUEs), do not apply to the DMEPOS fee schedule in California. In fact, none of the Physician Fee Schedule billing rules apply to the DMEPOS fee schedule, because the latter is not part of the Physician Fee Schedule.

This means that claims administrators cannot use MUE as a reason to deny or discount reimbursement for DME dispensed by a provider.

From the DWC Website FAQ:

Division of Workers’ Compensation Websites

DWC FAQ - About durable medical equipment (DME) dispensed by physician

DWC Official Medical Fee Schedule

daisyBill Solution

daisyBill’s easy billing software guarantees that workers’ comp bills are always submitted compliantly. Book a demo and see how easily daisyBill solves workers' comp billing problems.

REQUEST DEMO