Tips to prevent claim adjustment reason code (CARC) 54MUE

You receive this reason code when the units of service billed are in excess of the allowable units based on the Medicare National Correct Coding Initiative (NCCI) Edits policy for Medicare NCCI Medically Unlikely Edits (MUEs) If units billed are medically necessary, you can submit a request for a redetermination. Visit the Appealspage for information on the Medicare appeals process.

Tip: 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.

References

• Medicare NCCI Medically Unlikely Edits (MUEs)
• Medicare National Correct Coding Initiative (NCCI) Edits