FAQs on Observation, Condition Code 44 from the CMS website   QUESTION: May a hospital report drug administration services, such as therapeutic infusions, hydration services, or intravenous injections, furnished during the time period when observation services are being reported? ANSWER: The Medicare Claims Processing Manual (Pub 100-4), chapter 6, section 290.2.2 states that “observation services […]

What is the CMS Medically Unlikely Edit (MUE) program? The CMS Medically Unlikely Edit (MUE) program was developed to reduce the paid claims error rate for Medicare claims. MUEs are designed to reduce errors due to clerical entries and incorrect coding based on anatomic considerations, HCPCS/CPT code descriptors, CPT coding instructions, established CMS policies, nature […]