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Printed Date: 9/22/2015
No, a patient is not liable for a service that was denied for MUE. A denial of services due to an MUE is a coding denial, not a medical necessity denial. Therefore, the presence of an ABN does not shift liability to the beneficiary and ABN issuance based on an MUE is not appropriate.
Resource: MLN Article MM8853 - Revised Modification to the Medically Unlikely Edit (MUE) Program (PDF, 99 KB)
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Last Updated: 09/01/2020