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Last Modified: 11/30/2024 Location: FL, PR, USVI Business: Part B

Denial reason code 54MUE FAQ

Q: We received denial reason code 54MUE. What steps can we take to avoid this reason code?
A: You received this reason code because the units of service billed are in excess of the allowable units based on the Medicare National Correct Coding Initiative (NCCI) Edits external link policy for Medicare NCCI Medically Unlikely Edits (MUEs) external link. If units billed are medically necessary, you can submit a request for a redetermination. Visit the Appeals page for information on the Medicare appeals process.
Did you know you can refer to our Part A reason code lookup for a description associated with the Medicare Part A reason codes? Enter a valid reason code into the box and click the submit button.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.