Reduced Medically Unlikely Edits for Certain Lesion Removals
The 2019 first quarter CCIv25.0 Medically Unlikely Edits (MUEs) have been reduced for a selection of dermatology codes. These edits are developed from clinical data by the National Correct Coding Center (NCCI) provider by the Centers for Medicare & Medicaid Services (CMS). The MUEs limit the total number of units of a procedure or service that can be provided and reported per day.
There are 20 units of service reductions in the integumentary codes.
11308 (Shave skin lesion >2.0 cm) MUE value is now two, instead of four units.
11732 (Remove nail plate add-on) has been reduced from nine to four units,
The code series of 17282 and 17284-17286 (Destruction of skin malignant lesions) has lost one unit.
| Code | 2018 MUE Value | 2019 MUE Value | MUE Adjudication Indication (MAI) |
|---|---|---|---|
| 11308 | 8 | 4 | 3 Date of Service Edit: Clinical |
| 11732 | 9 | 4 | 3 Date of Service Edit: Clinical |
| 17282 | 5 | 4 | 3 Date of Service Edit: Clinical |
| 17283 | 4 | 4 | 3 Date of Service Edit: Clinical |
| 17284 | 4 | 2 | 3 Date of Service Edit: Clinical |
| 17286 | 3 | 2 | 3 Date of Service Edit: Clinical |
Although the units have been set by CMS, an MUE adjudication indication (MAI) of “1” and “3” may be appealed. For more information, visit the NCCI website at https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/MUE.html.
