medically unlikely edits (mues) - optum360 · medically unlikely edits (mues)—professional...
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Medically U
nlikely Edits (MU
Es)—Professional
Medically Unlikely Edits (MUEs)The Centers for Medicare & Medicaid Services (CMS) began to publish many of the edits used in the medically unlikely edits (MUE) program for the first time effective October 2008. What follows below is a list of the published CPT codes that have MUEs assigned to them and the number of units allowed with each code. CMS publishes the updates on a quarterly basis. Not all MUEs will be published, however. MUEs intended to detect and discourage any questionable payments will not be published as the agency feels the efficacy of these edits would be compromised. CMS added another component to the MUEs—the MUE Adjudication Indicator (MAI). The appropriate MAI can be found in parentheses following the MUE in this table and specify the maximum units of service (UOS) for a CPT/HCPCS code for the service. The MAI designates whether the UOS edit is applied to the line or claim.
The three MAIs are defined as follows:
MAI 1 (Line Edit) This MAI will continue to be adjudicated as the line edit on the claim and is auto-adjudicated by the contractor.
MAI 2 (Date of Service Edit, Policy) This MAI is considered to be the “absolute date of service edit” and is based on policy. The total unit of services (UOS) for that CPT code and that date of service (DOS) are combined for this edit. Medicare contractors are required to review all claims for the same patient, same date of service, and same provider.
MAI 3 (Date of Service Edit: Clinical) This MAI is also a date-of-service edit but is based upon clinical standards. The review takes current and previously submitted claims for the same patient, same date of service, and same provider into account. When medical necessity is clearly documented, the edit may be bypassed or the claim resubmitted.
The quarterly updates are published on the CMS website at http://www.cms.gov/NationalCorrectCodInitEd/08_MUE.asp.
Professional
HCPCS MUEA0021 0 (3)A0080 0 (3)A0090 0 (3)A0100 0 (3)A0110 0 (3)A0120 0 (3)A0130 0 (3)A0140 0 (3)A0160 0 (3)A0170 0 (3)A0180 0 (3)A0190 0 (3)A0200 0 (3)A0210 0 (3)A0225 0 (3)A0380 0 (3)A0382 0 (3)A0384 0 (3)A0390 0 (3)A0392 0 (3)A0394 0 (3)A0396 0 (3)A0398 0 (3)A0420 0 (3)A0422 0 (3)A0424 0 (3)A0425 250 (1)A0426 2 (3)A0427 2 (3)A0428 4 (3)A0429 2 (3)A0430 1 (3)A0431 1 (3)A0432 1 (3)A0433 1 (3)A0434 2 (3)A0435 999 (3)A0436 300 (3)A0888 0 (3)A0998 0 (3)A0999 1 (3)A4206 0 (3)A4207 0 (3)
A4208 0 (3)A4209 0 (3)A4210 0 (3)A4211 0 (3)A4212 0 (3)A4213 0 (3)A4215 0 (3)A4216 0 (3)A4217 0 (3)A4218 0 (3)A4220 1 (3)A4221 0 (3)A4222 0 (3)A4223 0 (3)A4224 0 (3)A4225 0 (3)A4230 0 (3)A4231 0 (3)A4232 0 (3)A4233 0 (3)A4234 0 (3)A4235 0 (3)A4236 0 (3)A4244 0 (3)A4245 0 (3)A4246 0 (3)A4247 0 (3)A4248 0 (3)A4250 0 (3)A4252 0 (3)A4253 0 (3)A4255 0 (3)A4256 0 (3)A4257 0 (3)A4258 0 (3)A4259 0 (3)A4261 0 (3)A4262 0 (3)A4263 0 (3)A4264 0 (3)A4265 0 (3)A4266 0 (3)A4267 0 (3)
HCPCS MUEA4268 0 (3)A4269 0 (3)A4270 0 (3)A4280 0 (3)A4281 0 (3)A4282 0 (3)A4283 0 (3)A4284 0 (3)A4285 0 (3)A4286 0 (3)A4290 2 (3)A4300 0 (3)A4301 1 (2)A4305 0 (3)A4306 0 (3)A4310 0 (3)A4311 0 (3)A4312 0 (3)A4313 0 (3)A4314 0 (3)A4315 0 (3)A4316 0 (3)A4320 0 (3)A4321 1 (3)A4322 0 (3)A4326 0 (3)A4327 0 (3)A4328 0 (3)A4330 0 (3)A4331 1 (3)A4332 2 (3)A4333 1 (3)A4334 1 (3)A4335 0 (3)A4336 1 (3)A4337 0 (3)A4338 0 (3)A4340 0 (3)A4344 0 (3)A4346 0 (3)A4349 1 (3)A4351 0 (3)A4352 0 (3)
HCPCS MUEA4353 1 (3)A4354 0 (3)A4355 0 (3)A4356 0 (3)A4357 0 (3)A4358 0 (3)A4360 1 (3)A4361 0 (3)A4362 0 (3)A4363 1 (3)A4364 0 (3)A4366 1 (3)A4367 0 (3)A4368 1 (3)A4369 1 (3)A4371 1 (3)A4372 1 (3)A4373 1 (3)A4375 2 (3)A4376 2 (3)A4377 2 (3)A4378 2 (3)A4379 2 (3)A4380 2 (3)A4381 2 (3)A4382 2 (3)A4383 2 (3)A4384 2 (3)A4385 2 (3)A4387 1 (3)A4388 1 (3)A4389 2 (3)A4390 1 (3)A4391 1 (3)A4392 2 (3)A4393 1 (3)A4394 1 (3)A4395 3 (3)A4396 2 (3)A4397 0 (3)A4398 0 (3)A4399 0 (3)A4400 0 (3)
HCPCS MUEA4402 0 (3)A4404 0 (3)A4405 1 (3)A4406 1 (3)A4407 2 (3)A4408 1 (3)A4409 1 (3)A4410 2 (3)A4411 1 (3)A4412 1 (3)A4413 2 (3)A4414 1 (3)A4415 1 (3)A4416 2 (3)A4417 2 (3)A4418 2 (3)A4419 2 (3)A4420 1 (3)A4422 7 (3)A4423 2 (3)A4424 1 (3)A4425 1 (3)A4426 2 (3)A4427 1 (3)A4428 1 (3)A4429 2 (3)A4430 1 (3)A4431 1 (3)A4432 2 (3)A4433 1 (3)A4434 1 (3)A4435 2 (3)A4450 0 (3)A4452 0 (3)A4455 0 (3)A4458 0 (3)A4459 0 (3)A4461 2 (3)A4463 0 (3)A4465 0 (3)A4467 0 (3)A4470 0 (3)A4480 0 (3)
HCPCS MUEA4481 0 (3)A4483 0 (3)A4490 0 (3)A4495 0 (3)A4500 0 (3)A4510 0 (3)A4520 0 (3)A4550 0 (3)A4553 0 (3)A4554 0 (3)A4555 0 (3)A4556 0 (3)A4557 0 (3)A4558 0 (3)A4559 0 (3)A4561 1 (3)A4562 1 (3)A4565 2 (3)A4566 0 (3)A4570 0 (3)A4575 0 (3)A4580 0 (3)A4590 0 (3)A4595 0 (3)A4600 0 (3)A4601 0 (3)A4602 0 (3)A4604 0 (3)A4605 0 (3)A4606 0 (3)A4608 0 (3)A4611 0 (3)A4612 0 (3)A4613 0 (3)A4614 0 (3)A4615 0 (3)A4616 0 (3)A4617 0 (3)A4618 1 (3)A4619 0 (3)A4620 0 (3)A4623 0 (3)A4624 0 (3)
HCPCS MUEA4625 30 (3)A4626 0 (3)A4627 0 (3)A4628 0 (3)A4629 0 (3)A4630 0 (3)A4633 0 (3)A4634 0 (3)A4635 0 (3)A4636 0 (3)A4637 0 (3)A4638 0 (3)A4639 0 (3)A4640 0 (3)A4642 1 (3)A4648 5 (3)A4649 1 (3)A4650 3 (3)A4651 0 (3)A4652 0 (3)A4653 0 (3)A4657 0 (3)A4660 0 (3)A4663 0 (3)A4670 0 (3)A4671 0 (3)A4672 0 (3)A4673 0 (3)A4674 0 (3)A4680 0 (3)A4690 0 (3)A4706 0 (3)A4707 0 (3)A4708 0 (3)A4709 0 (3)A4714 0 (3)A4719 0 (3)A4720 0 (3)A4721 0 (3)A4722 0 (3)A4723 0 (3)A4724 0 (3)A4725 0 (3)
HCPCS MUEA4726 0 (3)A4728 0 (3)A4730 0 (3)A4736 0 (3)A4737 0 (3)A4740 0 (3)A4750 0 (3)A4755 0 (3)A4760 0 (3)A4765 0 (3)A4766 0 (3)A4770 0 (3)A4771 0 (3)A4772 0 (3)A4773 0 (3)A4774 0 (3)A4802 0 (3)A4860 0 (3)A4870 0 (3)A4890 0 (3)A4911 0 (3)A4913 0 (3)A4918 0 (3)A4927 0 (3)A4928 0 (3)A4929 0 (3)A4930 0 (3)A4931 0 (3)A4932 0 (3)A5051 0 (3)A5052 0 (3)A5053 0 (3)A5054 0 (3)A5055 0 (3)A5056 90 (3)A5057 90 (3)A5061 0 (3)A5062 0 (3)A5063 0 (3)A5071 0 (3)A5072 0 (3)A5073 0 (3)A5081 0 (3)
HCPCS MUE
Medically Unlikely Edits (MUEs) 2019 HCPCS Level II
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A5082 0 (3)A5083 5 (3)A5093 0 (3)A5102 0 (3)A5105 0 (3)A5112 0 (3)A5113 0 (3)A5114 0 (3)A5120 150 (3)A5121 0 (3)A5122 0 (3)A5126 0 (3)A5131 0 (3)A5200 2 (3)A5500 0 (3)A5501 0 (3)A5503 0 (3)A5504 0 (3)A5505 0 (3)A5506 0 (3)A5507 0 (3)A5508 0 (3)A5510 0 (3)A5512 0 (3)A5513 0 (3)A6000 0 (3)A6010 0 (3)A6011 0 (3)A6021 0 (3)A6022 0 (3)A6023 0 (3)A6024 0 (3)A6025 0 (3)A6154 0 (3)A6196 0 (3)A6197 0 (3)A6198 0 (3)A6199 0 (3)A6203 0 (3)A6204 0 (3)A6205 0 (3)A6206 0 (3)A6207 0 (3)A6208 0 (3)A6209 0 (3)A6210 0 (3)A6211 0 (3)A6212 0 (3)A6213 0 (3)A6214 0 (3)A6215 0 (3)A6216 0 (3)A6217 0 (3)A6218 0 (3)A6219 0 (3)A6220 0 (3)A6221 0 (3)A6222 0 (3)A6223 0 (3)A6224 0 (3)A6228 0 (3)A6229 0 (3)A6230 0 (3)A6231 0 (3)A6232 0 (3)
HCPCS MUEA6233 0 (3)A6234 0 (3)A6235 0 (3)A6236 0 (3)A6237 0 (3)A6238 0 (3)A6239 0 (3)A6240 0 (3)A6241 0 (3)A6242 0 (3)A6243 0 (3)A6244 0 (3)A6245 0 (3)A6246 0 (3)A6247 0 (3)A6248 0 (3)A6250 0 (3)A6251 0 (3)A6252 0 (3)A6253 0 (3)A6254 0 (3)A6255 0 (3)A6256 0 (3)A6257 0 (3)A6258 0 (3)A6259 0 (3)A6260 0 (3)A6261 0 (3)A6262 0 (3)A6266 0 (3)A6402 0 (3)A6403 0 (3)A6404 0 (3)A6407 0 (3)A6410 2 (3)A6411 0 (3)A6412 0 (3)A6413 0 (3)A6441 0 (3)A6442 0 (3)A6443 0 (3)A6444 0 (3)A6445 0 (3)A6446 0 (3)A6447 0 (3)A6448 0 (3)A6449 0 (3)A6450 0 (3)A6451 0 (3)A6452 0 (3)A6453 0 (3)A6454 0 (3)A6455 0 (3)A6456 0 (3)A6457 0 (3)A6501 0 (3)A6502 0 (3)A6503 0 (3)A6504 0 (3)A6505 0 (3)A6506 0 (3)A6507 0 (3)A6508 0 (3)A6509 0 (3)A6510 0 (3)
HCPCS MUEA6511 0 (3)A6513 0 (3)A6530 0 (3)A6531 0 (3)A6532 0 (3)A6533 0 (3)A6534 0 (3)A6535 0 (3)A6536 0 (3)A6537 0 (3)A6538 0 (3)A6539 0 (3)A6540 0 (3)A6541 0 (3)A6544 0 (3)A6545 0 (3)A6549 0 (3)A6550 0 (3)A7000 0 (3)A7001 0 (3)A7002 0 (3)A7003 0 (3)A7004 0 (3)A7005 0 (3)A7006 0 (3)A7007 0 (3)A7008 0 (3)A7009 0 (3)A7010 0 (3)A7012 0 (3)A7013 0 (3)A7014 0 (3)A7015 0 (3)A7016 0 (3)A7017 0 (3)A7018 0 (3)A7020 0 (3)A7025 0 (3)A7026 0 (3)A7027 0 (3)A7028 0 (3)A7029 0 (3)A7030 0 (3)A7031 0 (3)A7032 0 (3)A7033 0 (3)A7034 0 (3)A7035 0 (3)A7036 0 (3)A7037 0 (3)A7038 0 (3)A7039 0 (3)A7040 2 (3)A7041 2 (3)A7044 0 (3)A7045 0 (3)A7046 0 (3)A7047 0 (3)A7048 2 (3)A7501 0 (3)A7502 0 (3)A7503 0 (3)A7504 0 (3)A7505 0 (3)A7506 0 (3)
HCPCS MUEA7507 0 (3)A7508 0 (3)A7509 0 (3)A7520 0 (3)A7521 0 (3)A7522 0 (3)A7523 0 (3)A7524 0 (3)A7525 0 (3)A7526 0 (3)A7527 0 (3)A8000 0 (3)A8001 0 (3)A8002 0 (3)A8003 0 (3)A8004 0 (3)A9152 0 (3)A9153 0 (3)A9155 1 (3)A9180 0 (3)A9270 0 (3)A9272 0 (3)A9273 0 (3)A9274 0 (3)A9275 0 (3)A9276 0 (3)A9277 0 (3)A9278 0 (3)A9279 0 (3)A9280 0 (3)A9281 0 (3)A9282 0 (3)A9283 0 (3)A9284 0 (3)A9285 0 (3)A9286 0 (3)A9300 0 (3)A9500 3 (3)A9501 1 (3)A9502 3 (3)A9503 1 (3)A9504 1 (3)A9505 4 (3)A9507 1 (3)A9508 2 (3)A9509 5 (3)A9510 1 (3)A9512 30 (3)A9515 1 (3)A9516 4 (3)A9517 200 (3)A9520 1 (3)A9521 2 (3)A9524 10 (3)A9526 2 (3)A9527 195 (3)A9528 10 (3)A9529 10 (3)A9530 200 (3)A9531 100 (3)A9532 10 (3)A9536 1 (3)A9537 1 (3)A9538 1 (3)A9539 2 (3)
HCPCS MUEA9540 2 (3)A9541 1 (3)A9542 1 (3)A9543 1 (3)A9546 1 (3)A9547 2 (3)A9548 2 (3)A9550 1 (3)A9551 1 (3)A9552 1 (3)A9553 1 (3)A9554 1 (3)A9555 2 (3)A9556 10 (3)A9557 2 (3)A9558 7 (3)A9559 1 (3)A9560 2 (3)A9561 1 (3)A9562 2 (3)A9563 10 (3)A9564 20 (3)A9566 1 (3)A9567 2 (3)A9568 0 (3)A9569 1 (3)A9570 1 (3)A9571 1 (3)A9572 1 (3)A9575 300 (3)A9576 40 (3)A9577 50 (3)A9578 50 (3)A9579 100 (3)A9580 1 (3)A9581 20 (3)A9582 1 (3)A9583 18 (3)A9584 1 (3)A9585 300 (3)A9586 1 (3)A9587 54 (3)A9588 10 (3)A9600 7 (3)A9604 1 (3)A9606 224 (3)A9698 2 (3)A9700 2 (3)A9900 1 (3)A9901 0 (3)A9999 1 (3)B4034 0 (3)B4035 0 (3)B4036 0 (3)B4081 0 (3)B4082 0 (3)B4083 0 (3)B4087 0 (3)B4088 0 (3)B4100 0 (3)B4102 0 (3)B4103 0 (3)B4104 0 (3)B4149 0 (3)B4150 0 (3)
HCPCS MUEB4152 0 (3)B4153 0 (3)B4154 0 (3)B4155 0 (3)B4157 0 (3)B4158 0 (3)B4159 0 (3)B4160 0 (3)B4161 0 (3)B4162 0 (3)B4164 0 (3)B4168 0 (3)B4172 0 (3)B4176 0 (3)B4178 0 (3)B4180 0 (3)B4185 0 (3)B4189 0 (3)B4193 0 (3)B4197 0 (3)B4199 0 (3)B4216 0 (3)B4220 0 (3)B4222 0 (3)B4224 0 (3)B5000 0 (3)B5100 0 (3)B5200 0 (3)B9002 0 (3)B9004 0 (3)B9006 0 (3)B9998 0 (3)B9999 0 (3)C1713 20 (3)C1714 4 (3)C1715 45 (3)C1716 4 (3)C1717 10 (3)C1719 99 (3)C1721 1 (3)C1722 1 (3)C1724 5 (3)C1725 9 (3)C1726 5 (3)C1727 4 (3)C1728 5 (3)C1729 6 (3)C1730 4 (3)C1731 2 (3)C1732 3 (3)C1733 3 (3)C1749 1 (3)C1750 2 (3)C1751 3 (3)C1752 2 (3)C1753 2 (3)C1754 2 (3)C1755 2 (3)C1756 2 (3)C1757 6 (3)C1758 2 (3)C1759 2 (3)C1760 4 (3)C1762 4 (3)C1763 4 (3)
HCPCS MUEC1764 1 (3)C1765 4 (3)C1766 4 (3)C1767 2 (3)C1768 3 (3)C1769 9 (3)C1770 3 (3)C1771 1 (3)C1772 1 (3)C1773 3 (3)C1776 10 (3)C1777 2 (3)C1778 4 (3)C1779 2 (3)C1780 2 (3)C1781 4 (3)C1782 1 (3)C1783 2 (3)C1784 2 (3)C1785 1 (3)C1786 1 (3)C1787 2 (3)C1788 2 (3)C1789 2 (3)C1813 1 (3)C1814 2 (3)C1815 1 (3)C1816 2 (3)C1817 1 (3)C1818 2 (3)C1819 4 (3)C1820 2 (3)C1821 4 (3)C1822 1 (3)C1830 2 (3)C1840 1 (3)C1841 1 (2)C1842 1 (2)C1874 5 (3)C1875 4 (3)C1876 5 (3)C1877 5 (3)C1878 2 (3)C1880 2 (3)C1881 2 (3)C1882 1 (3)C1883 4 (3)C1884 4 (3)C1885 2 (3)C1886 1 (3)C1887 7 (3)C1888 2 (3)C1889 1 (3)C1891 1 (3)C1892 6 (3)C1893 6 (3)C1894 6 (3)C1895 2 (3)C1896 2 (3)C1897 2 (3)C1898 2 (3)C1899 2 (3)C1900 1 (3)C2613 2 (3)C2614 3 (3)
HCPCS MUEC2615 2 (3)C2616 1 (3)C2617 4 (3)C2618 4 (3)C2619 1 (3)C2620 1 (3)C2621 1 (3)C2622 1 (3)C2623 2 (3)C2624 1 (3)C2625 4 (3)C2626 1 (3)C2627 2 (3)C2628 4 (3)C2629 4 (3)C2630 3 (3)C2631 1 (3)C2634 24 (3)C2635 124 (3)C2636 690 (3)C2637 0 (3)C2638 150 (3)C2639 150 (3)C2640 150 (3)C2641 150 (3)C2642 120 (3)C2643 120 (3)C2644 500 (1)C2645 4608 (3)C5271 1 (2)C5272 3 (2)C5273 1 (2)C5274 35 (3)C5275 1 (2)C5276 3 (2)C5277 1 (2)C5278 15 (3)C8900 1 (3)C8901 1 (3)C8902 1 (3)C8903 1 (3)C8905 1 (3)C8906 1 (3)C8908 1 (3)C8909 1 (3)C8910 1 (3)C8911 1 (3)C8912 1 (3)C8913 1 (3)C8914 1 (3)C8918 1 (3)C8919 1 (3)C8920 1 (3)C8921 1 (3)C8922 1 (3)C8923 1 (3)C8924 1 (3)C8925 1 (3)C8926 1 (3)C8927 1 (3)C8928 1 (2)C8929 1 (3)C8930 1 (2)C8931 1 (3)C8932 1 (3)
HCPCS MUE
2019 HCPCS Level II Medically Unlikely Edits (MUEs)
© 2018 Optum360, LLC 3
Medically U
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C8933 1 (3)C8934 2 (3)C8935 2 (3)C8936 2 (3)C8957 2 (3)C9113 10 (3)C9132 5500 (3)C9248 25 (3)C9250 1 (3)C9254 400 (3)C9257 5 (3)C9285 2 (3)C9290 266 (3)C9293 700 (3)C9352 3 (3)C9353 4 (3)C9354 300 (3)C9355 3 (3)C9356 125 (3)C9358 800 (3)C9359 30 (3)C9360 300 (3)C9361 10 (3)C9362 60 (3)C9363 500 (3)C9364 600 (3)C9447 1 (3)C9460 1 (3)C9462 600 (3)C9482 150 (3)C9488 20 (3)C9600 3 (3)C9601 2 (3)C9602 2 (3)C9603 2 (3)C9604 2 (3)C9605 2 (3)C9606 1 (3)C9607 1 (2)C9608 2 (3)C9725 1 (3)C9726 2 (3)C9727 1 (2)C9728 1 (2)C9733 1 (3)C9734 1 (3)C9738 1 (3)C9739 1 (2)C9740 1 (2)C9745 2 (2)C9746 1 (2)C9747 1 (2)C9749 1 (2)E0100 0 (3)E0105 0 (3)E0110 0 (3)E0111 0 (3)E0112 0 (3)E0113 0 (3)E0114 0 (3)E0116 0 (3)E0117 0 (3)E0118 0 (3)E0130 0 (3)E0135 0 (3)
HCPCS MUEE0140 0 (3)E0141 0 (3)E0143 0 (3)E0144 0 (3)E0147 0 (3)E0148 0 (3)E0149 0 (3)E0153 0 (3)E0154 0 (3)E0155 0 (3)E0156 0 (3)E0157 0 (3)E0158 0 (3)E0159 2 (2)E0160 0 (3)E0161 0 (3)E0162 0 (3)E0163 0 (3)E0165 0 (3)E0167 0 (3)E0168 0 (3)E0170 0 (3)E0171 0 (3)E0172 0 (3)E0175 0 (3)E0181 0 (3)E0182 0 (3)E0184 0 (3)E0185 0 (3)E0186 0 (3)E0187 0 (3)E0188 0 (3)E0189 0 (3)E0190 0 (3)E0191 0 (3)E0193 0 (3)E0194 0 (3)E0196 0 (3)E0197 0 (3)E0198 0 (3)E0199 0 (3)E0200 0 (3)E0202 0 (3)E0203 0 (3)E0205 0 (3)E0210 0 (3)E0215 0 (3)E0217 0 (3)E0218 0 (3)E0221 0 (3)E0225 0 (3)E0231 0 (3)E0232 0 (3)E0235 0 (3)E0236 0 (3)E0239 0 (3)E0240 0 (3)E0241 0 (3)E0242 0 (3)E0243 0 (3)E0244 0 (3)E0245 0 (3)E0246 0 (3)E0247 0 (3)E0248 0 (3)
HCPCS MUEE0249 0 (3)E0250 0 (3)E0251 0 (3)E0255 0 (3)E0256 0 (3)E0260 0 (3)E0261 0 (3)E0265 0 (3)E0266 0 (3)E0270 0 (3)E0271 0 (3)E0272 0 (3)E0273 0 (3)E0274 0 (3)E0275 0 (3)E0276 0 (3)E0277 0 (3)E0280 0 (3)E0290 0 (3)E0291 0 (3)E0292 0 (3)E0293 0 (3)E0294 0 (3)E0295 0 (3)E0296 0 (3)E0297 0 (3)E0300 0 (3)E0301 0 (3)E0302 0 (3)E0303 0 (3)E0304 0 (3)E0305 0 (3)E0310 0 (3)E0315 0 (3)E0316 0 (3)E0325 0 (3)E0326 0 (3)E0328 0 (3)E0329 0 (3)E0350 0 (3)E0352 0 (3)E0370 0 (3)E0371 0 (3)E0372 0 (3)E0373 0 (3)E0424 0 (3)E0425 0 (3)E0430 0 (3)E0431 0 (3)E0433 0 (3)E0434 0 (3)E0435 0 (3)E0439 0 (3)E0440 0 (3)E0441 0 (3)E0442 0 (3)E0443 0 (3)E0444 0 (3)E0445 0 (3)E0446 0 (3)E0455 0 (3)E0457 0 (3)E0459 0 (3)E0462 0 (3)E0465 0 (3)
HCPCS MUEE0466 0 (3)E0470 0 (3)E0471 0 (3)E0472 0 (3)E0480 0 (3)E0481 0 (3)E0482 0 (3)E0483 0 (3)E0484 0 (3)E0485 0 (3)E0486 0 (3)E0487 0 (3)E0500 0 (3)E0550 0 (3)E0555 0 (3)E0560 0 (3)E0561 0 (3)E0562 0 (3)E0565 0 (3)E0570 0 (3)E0572 0 (3)E0574 0 (3)E0575 0 (3)E0580 0 (3)E0585 0 (3)E0600 0 (3)E0601 0 (3)E0602 0 (3)E0603 0 (3)E0604 0 (3)E0605 0 (3)E0606 0 (3)E0607 0 (3)E0610 0 (3)E0615 0 (3)E0616 1 (2)E0617 0 (3)E0618 0 (3)E0619 0 (3)E0620 0 (3)E0621 0 (3)E0625 0 (3)E0627 0 (3)E0629 0 (3)E0630 0 (3)E0635 0 (3)E0636 0 (3)E0637 0 (3)E0638 0 (3)E0639 0 (3)E0640 0 (3)E0641 0 (3)E0642 0 (3)E0650 0 (3)E0651 0 (3)E0652 0 (3)E0655 0 (3)E0656 0 (3)E0657 0 (3)E0660 0 (3)E0665 0 (3)E0666 0 (3)E0667 0 (3)E0668 0 (3)E0669 0 (3)
HCPCS MUEE0670 0 (3)E0671 0 (3)E0672 0 (3)E0673 0 (3)E0675 0 (3)E0676 1 (3)E0691 0 (3)E0692 0 (3)E0693 0 (3)E0694 0 (3)E0700 0 (3)E0705 0 (3)E0710 0 (3)E0720 0 (3)E0730 0 (3)E0731 0 (3)E0740 0 (3)E0744 0 (3)E0745 0 (3)E0746 1 (3)E0747 0 (3)E0748 0 (3)E0749 1 (3)E0755 0 (3)E0760 0 (3)E0761 0 (3)E0762 0 (3)E0764 0 (3)E0765 0 (3)E0766 0 (3)E0769 0 (3)E0770 1 (3)E0776 0 (3)E0779 0 (3)E0780 0 (3)E0781 1 (2)E0782 1 (2)E0783 1 (2)E0784 0 (3)E0785 1 (2)E0786 1 (2)E0791 0 (3)E0830 0 (3)E0840 0 (3)E0849 0 (3)E0850 0 (3)E0855 0 (3)E0856 0 (3)E0860 0 (3)E0870 0 (3)E0880 0 (3)E0890 0 (3)E0900 0 (3)E0910 0 (3)E0911 0 (3)E0912 0 (3)E0920 0 (3)E0930 0 (3)E0935 0 (3)E0936 0 (3)E0940 0 (3)E0941 0 (3)E0942 0 (3)E0944 0 (3)E0945 0 (3)
HCPCS MUEE0946 0 (3)E0947 0 (3)E0948 0 (3)E0950 0 (3)E0951 0 (3)E0952 0 (3)E0953 0 (3)E0954 0 (3)E0955 0 (3)E0956 0 (3)E0957 0 (3)E0958 0 (3)E0959 0 (3)E0960 0 (3)E0961 0 (3)E0966 0 (3)E0967 0 (3)E0968 0 (3)E0969 0 (3)E0970 0 (3)E0971 0 (3)E0973 0 (3)E0974 0 (3)E0978 0 (3)E0980 0 (3)E0981 0 (3)E0982 0 (3)E0983 0 (3)E0984 0 (3)E0985 0 (3)E0986 0 (3)E0988 0 (3)E0990 0 (3)E0992 0 (3)E0994 0 (3)E0995 0 (3)E1002 0 (3)E1003 0 (3)E1004 0 (3)E1005 0 (3)E1006 0 (3)E1007 0 (3)E1008 0 (3)E1009 0 (3)E1010 0 (3)E1011 0 (3)E1012 0 (3)E1014 0 (3)E1015 0 (3)E1016 0 (3)E1017 0 (3)E1018 0 (3)E1020 0 (3)E1028 0 (3)E1029 0 (3)E1030 0 (3)E1031 0 (3)E1035 0 (3)E1036 0 (3)E1037 0 (3)E1038 0 (3)E1039 0 (3)E1050 0 (3)E1060 0 (3)E1070 0 (3)
HCPCS MUEE1083 0 (3)E1084 0 (3)E1085 0 (3)E1086 0 (3)E1087 0 (3)E1088 0 (3)E1089 0 (3)E1090 0 (3)E1092 0 (3)E1093 0 (3)E1100 0 (3)E1110 0 (3)E1130 0 (3)E1140 0 (3)E1150 0 (3)E1160 0 (3)E1161 0 (3)E1170 0 (3)E1171 0 (3)E1172 0 (3)E1180 0 (3)E1190 0 (3)E1195 0 (3)E1200 0 (3)E1220 0 (3)E1221 0 (3)E1222 0 (3)E1223 0 (3)E1224 0 (3)E1225 0 (3)E1226 0 (3)E1227 0 (3)E1228 0 (3)E1229 0 (3)E1230 0 (3)E1231 0 (3)E1232 0 (3)E1233 0 (3)E1234 0 (3)E1235 0 (3)E1236 0 (3)E1237 0 (3)E1238 0 (3)E1239 0 (3)E1240 0 (3)E1250 0 (3)E1260 0 (3)E1270 0 (3)E1280 0 (3)E1285 0 (3)E1290 0 (3)E1295 0 (3)E1296 0 (3)E1297 0 (3)E1298 0 (3)E1300 0 (3)E1310 0 (3)E1352 0 (3)E1353 0 (3)E1354 0 (3)E1355 0 (3)E1356 0 (3)E1357 0 (3)E1358 0 (3)E1372 0 (3)
HCPCS MUEE1390 0 (3)E1391 0 (3)E1392 0 (3)E1399 1 (3)E1405 0 (3)E1406 0 (3)E1500 0 (3)E1510 0 (3)E1520 0 (3)E1530 0 (3)E1540 0 (3)E1550 0 (3)E1560 0 (3)E1570 0 (3)E1575 0 (3)E1580 0 (3)E1590 0 (3)E1592 0 (3)E1594 0 (3)E1600 0 (3)E1610 0 (3)E1615 0 (3)E1620 0 (3)E1625 0 (3)E1630 0 (3)E1632 0 (3)E1634 0 (3)E1635 0 (3)E1636 0 (3)E1637 0 (3)E1639 0 (3)E1699 0 (3)E1700 0 (3)E1701 0 (3)E1702 0 (3)E1800 0 (3)E1801 0 (3)E1802 0 (3)E1805 0 (3)E1806 0 (3)E1810 0 (3)E1811 0 (3)E1812 0 (3)E1815 0 (3)E1816 0 (3)E1818 0 (3)E1820 0 (3)E1821 0 (3)E1825 0 (3)E1830 0 (3)E1831 0 (3)E1840 0 (3)E1841 0 (3)E1902 0 (3)E2000 0 (3)E2100 0 (3)E2101 0 (3)E2120 0 (3)E2201 0 (3)E2202 0 (3)E2203 0 (3)E2204 0 (3)E2205 0 (3)E2206 0 (3)E2207 0 (3)
HCPCS MUE
Medically Unlikely Edits (MUEs) 2019 HCPCS Level II
4 © 2018 Optum360, LLC
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E2208 0 (3)E2209 0 (3)E2210 0 (3)E2211 0 (3)E2212 0 (3)E2213 0 (3)E2214 0 (3)E2215 0 (3)E2216 0 (3)E2217 0 (3)E2218 0 (3)E2219 0 (3)E2220 0 (3)E2221 0 (3)E2222 0 (3)E2224 0 (3)E2225 0 (3)E2226 0 (3)E2227 0 (3)E2228 0 (3)E2230 0 (3)E2231 0 (3)E2291 1 (2)E2292 1 (2)E2293 1 (2)E2294 1 (2)E2295 0 (3)E2300 0 (3)E2301 0 (3)E2310 0 (3)E2311 0 (3)E2312 0 (3)E2313 0 (3)E2321 0 (3)E2322 0 (3)E2323 0 (3)E2324 0 (3)E2325 0 (3)E2326 0 (3)E2327 0 (3)E2328 0 (3)E2329 0 (3)E2330 0 (3)E2331 0 (3)E2340 0 (3)E2341 0 (3)E2342 0 (3)E2343 0 (3)E2351 0 (3)E2358 0 (3)E2359 0 (3)E2360 0 (3)E2361 0 (3)E2362 0 (3)E2363 0 (3)E2364 0 (3)E2365 0 (3)E2366 0 (3)E2367 0 (3)E2368 0 (3)E2369 0 (3)E2370 0 (3)E2371 0 (3)E2372 0 (3)E2373 0 (3)
HCPCS MUEE2374 0 (3)E2375 0 (3)E2376 0 (3)E2377 0 (3)E2378 0 (3)E2381 0 (3)E2382 0 (3)E2383 0 (3)E2384 0 (3)E2385 0 (3)E2386 0 (3)E2387 0 (3)E2388 0 (3)E2389 0 (3)E2390 0 (3)E2391 0 (3)E2392 0 (3)E2394 0 (3)E2395 0 (3)E2396 0 (3)E2397 0 (3)E2402 0 (3)E2500 0 (3)E2502 0 (3)E2504 0 (3)E2506 0 (3)E2508 0 (3)E2510 0 (3)E2511 0 (3)E2512 0 (3)E2599 0 (3)E2601 0 (3)E2602 0 (3)E2603 0 (3)E2604 0 (3)E2605 0 (3)E2606 0 (3)E2607 0 (3)E2608 0 (3)E2609 0 (3)E2610 0 (3)E2611 0 (3)E2612 0 (3)E2613 0 (3)E2614 0 (3)E2615 0 (3)E2616 0 (3)E2617 0 (3)E2619 0 (3)E2620 0 (3)E2621 0 (3)E2622 0 (3)E2623 0 (3)E2624 0 (3)E2625 0 (3)E2626 0 (3)E2627 0 (3)E2628 0 (3)E2629 0 (3)E2630 0 (3)E2631 0 (3)E2632 0 (3)E2633 0 (3)E8000 0 (3)E8001 0 (3)
HCPCS MUEE8002 0 (3)G0008 1 (2)G0009 1 (2)G0010 1 (3)G0027 1 (2)G0101 1 (2)G0102 1 (2)G0103 1 (2)G0104 1 (2)G0105 1 (2)G0106 1 (2)G0108 6 (3)G0109 12 (3)G0117 1 (2)G0118 1 (2)G0120 1 (2)G0121 1 (2)G0122 0 (3)G0123 1 (3)G0124 1 (3)G0127 1 (2)G0128 1 (3)G0130 1 (2)G0141 1 (3)G0143 1 (3)G0144 1 (3)G0145 1 (3)G0147 1 (3)G0148 1 (3)G0166 2 (3)G0168 2 (3)G0175 1 (3)G0177 0 (3)G0179 1 (2)G0180 1 (2)G0181 1 (2)G0182 1 (2)G0186 1 (2)G0219 0 (3)G0235 1 (3)G0237 8 (3)G0238 8 (3)G0239 1 (3)G0245 1 (2)G0246 1 (2)G0247 1 (2)G0248 1 (2)G0249 3 (3)G0250 1 (2)G0252 0 (3)G0255 0 (3)G0257 0 (3)G0259 2 (3)G0260 2 (3)G0268 1 (2)G0269 0 (3)G0270 8 (3)G0271 4 (3)G0276 1 (3)G0277 5 (3)G0278 1 (2)G0279 1 (2)G0281 1 (3)G0282 0 (3)G0283 1 (3)
HCPCS MUEG0288 1 (2)G0289 1 (2)G0293 1 (2)G0294 1 (2)G0295 0 (3)G0296 1 (2)G0297 1 (2)G0302 1 (2)G0303 1 (2)G0304 1 (2)G0305 1 (2)G0306 1 (3)G0307 1 (3)G0328 1 (2)G0329 1 (3)G0333 0 (3)G0337 1 (2)G0339 1 (2)G0340 1 (3)G0341 1 (2)G0342 1 (2)G0343 1 (2)G0365 2 (3)G0372 1 (2)G0378 0 (3)G0379 0 (3)G0380 0 (3)G0381 0 (3)G0382 0 (3)G0383 0 (3)G0384 0 (3)G0390 0 (3)G0396 1 (2)G0397 1 (2)G0398 1 (2)G0399 1 (2)G0400 1 (2)G0402 1 (2)G0403 1 (2)G0404 1 (2)G0405 1 (2)G0406 1 (3)G0407 1 (3)G0408 1 (3)G0410 4 (3)G0411 4 (3)G0412 1 (2)G0413 1 (2)G0414 1 (2)G0415 1 (2)G0416 1 (2)G0420 2 (3)G0421 4 (3)G0422 6 (2)G0423 6 (2)G0424 2 (2)G0425 1 (3)G0426 1 (3)G0427 1 (3)G0428 0 (3)G0429 1 (2)G0432 1 (2)G0433 1 (2)G0435 1 (2)G0438 1 (2)
HCPCS MUEG0439 1 (2)G0442 1 (2)G0443 1 (2)G0444 1 (2)G0445 1 (2)G0446 1 (3)G0448 1 (3)G0451 1 (3)G0452 6 (3)G0453 40 (3)G0454 1 (2)G0455 1 (2)G0458 1 (3)G0459 1 (3)G0460 1 (3)G0463 0 (3)G0466 1 (2)G0467 1 (3)G0468 1 (2)G0469 1 (2)G0470 1 (3)G0471 2 (3)G0472 1 (2)G0473 1 (3)G0475 1 (2)G0476 1 (2)G0480 1 (2)G0481 1 (2)G0482 1 (2)G0483 1 (2)G0490 1 (3)G0491 1 (3)G0492 1 (3)G0493 1 (3)G0494 1 (3)G0495 1 (3)G0496 1 (3)G0498 1 (2)G0499 1 (2)G0500 1 (3)G0501 0 (3)G0506 1 (2)G0508 1 (2)G0509 1 (2)G0511 1 (2)G0512 1 (2)G0513 1 (2)G0514 1 (1)G0515 8 (3)G0516 1 (2)G0517 1 (2)G0518 1 (2)G0659 1 (2)G6001 2 (3)G6002 2 (3)G6003 2 (3)G6004 2 (3)G6005 2 (3)G6006 2 (3)G6007 2 (3)G6008 2 (3)G6009 2 (3)G6010 2 (3)G6011 2 (3)G6012 2 (3)
HCPCS MUEG6013 2 (3)G6014 2 (3)G6015 2 (3)G6016 2 (3)G6017 2 (3)G9143 1 (2)G9147 0 (3)G9148 1 (3)G9149 1 (3)G9150 1 (3)G9151 1 (3)G9152 1 (3)G9153 1 (3)G9156 1 (2)G9157 1 (2)G9187 1 (3)G9480 1 (3)G9481 1 (3)G9482 1 (3)G9483 1 (3)G9484 1 (3)G9485 1 (3)G9486 1 (3)G9487 1 (3)G9488 1 (3)G9489 1 (3)G9490 1 (3)G9678 1 (2)G9685 1 (3)J0120 1 (3)J0129 100 (3)J0130 4 (3)J0131 400 (3)J0132 12 (3)J0133 1200 (3)J0135 8 (3)J0153 180 (3)J0171 20 (3)J0178 4 (3)J0180 125 (3)J0190 0 (3)J0200 0 (3)J0202 12 (3)J0205 0 (3)J0207 4 (3)J0210 4 (3)J0215 30 (3)J0220 1 (3)J0221 250 (3)J0256 1600 (3)J0257 1400 (3)J0270 32 (3)J0275 1 (3)J0278 15 (3)J0280 7 (3)J0282 5 (3)J0285 5 (3)J0287 50 (3)J0288 0 (3)J0289 50 (3)J0290 24 (3)J0295 12 (3)J0300 8 (3)J0330 10 (3)J0348 200 (3)
HCPCS MUEJ0350 0 (3)J0360 2 (3)J0364 6 (3)J0365 0 (3)J0380 1 (3)J0390 0 (3)J0395 0 (3)J0400 39 (3)J0401 400 (3)J0456 4 (3)J0461 200 (3)J0470 2 (3)J0475 8 (3)J0476 2 (3)J0480 1 (3)J0485 1500 (3)J0490 160 (3)J0500 4 (3)J0515 3 (3)J0520 0 (3)J0558 24 (3)J0561 24 (3)J0565 200 (3)J0570 4 (3)J0571 0 (3)J0572 0 (3)J0573 0 (3)J0574 0 (3)J0575 0 (3)J0583 250 (3)J0585 600 (3)J0586 300 (3)J0587 300 (3)J0588 600 (3)J0592 6 (3)J0594 320 (3)J0595 8 (3)J0596 840 (3)J0597 250 (3)J0598 100 (3)J0600 3 (3)J0604 0 (3)J0606 150 (3)J0610 15 (3)J0620 1 (3)J0630 1 (3)J0636 100 (3)J0637 20 (3)J0638 150 (3)J0640 24 (3)J0641 1200 (3)J0670 10 (3)J0690 12 (3)J0692 12 (3)J0694 8 (3)J0695 60 (3)J0696 16 (3)J0697 4 (3)J0698 10 (3)J0702 18 (3)J0706 1 (3)J0710 0 (3)J0712 120 (3)J0713 12 (3)J0714 4 (3)
HCPCS MUEJ0715 0 (3)J0716 4 (3)J0717 400 (3)J0720 15 (3)J0725 10 (3)J0735 50 (3)J0740 2 (3)J0743 16 (3)J0744 6 (3)J0745 2 (3)J0770 5 (3)J0775 180 (3)J0780 4 (3)J0795 100 (3)J0800 3 (3)J0834 3 (3)J0840 6 (3)J0850 9 (3)J0875 300 (3)J0878 1500 (3)J0881 500 (3)J0882 300 (3)J0883 1125 (3)J0884 1125 (3)J0885 60 (3)J0887 360 (3)J0888 360 (3)J0890 0 (3)J0894 100 (3)J0895 12 (3)J0897 120 (3)J0945 4 (3)J1000 1 (3)J1020 8 (3)J1030 8 (3)J1040 4 (3)J1050 1000 (3)J1071 400 (3)J1094 0 (3)J1100 120 (3)J1110 3 (3)J1120 2 (3)J1130 300 (3)J1160 2 (3)J1162 1 (3)J1165 50 (3)J1170 350 (3)J1180 0 (3)J1190 8 (3)J1200 8 (3)J1205 4 (3)J1212 1 (3)J1230 3 (3)J1240 6 (3)J1245 6 (3)J1250 2 (3)J1260 2 (3)J1265 20 (3)J1267 150 (3)J1270 8 (3)J1290 30 (3)J1300 120 (3)J1320 0 (3)J1322 150 (3)J1324 108 (3)
HCPCS MUE
2019 HCPCS Level II Medically Unlikely Edits (MUEs)
© 2018 Optum360, LLC 5
Medically U
nlikely Edits (MU
Es)—Professional
J1325 1 (3)J1327 1 (3)J1330 1 (3)J1335 2 (3)J1364 2 (3)J1380 4 (3)J1410 4 (3)J1428 450 (3)J1430 10 (3)J1435 1 (3)J1436 0 (3)J1438 2 (3)J1439 750 (3)J1442 1500 (3)J1443 272 (3)J1447 960 (3)J1450 4 (3)J1451 1 (3)J1452 0 (3)J1453 150 (3)J1455 18 (3)J1457 0 (3)J1458 100 (3)J1459 300 (3)J1460 10 (2)J1555 480 (3)J1556 300 (3)J1557 300 (3)J1559 300 (3)J1560 1 (2)J1561 300 (3)J1562 0 (3)J1566 300 (3)J1568 300 (3)J1569 300 (3)J1570 4 (3)J1571 20 (3)J1572 300 (3)J1573 130 (3)J1575 650 (3)J1580 9 (3)J1595 1 (3)J1599 300 (3)J1600 2 (3)J1602 300 (3)J1610 2 (3)J1620 0 (3)J1626 30 (3)J1627 100 (3)J1630 5 (3)J1631 9 (3)J1640 672 (3)J1642 100 (3)J1644 40 (3)J1645 10 (3)J1650 30 (3)J1652 20 (3)J1655 0 (3)J1670 1 (3)J1675 0 (3)J1700 0 (3)J1710 0 (3)J1720 10 (3)J1726 28 (3)J1729 700 (3)
HCPCS MUEJ1730 0 (3)J1740 3 (3)J1741 8 (3)J1742 2 (3)J1743 66 (3)J1744 30 (3)J1745 150 (3)J1750 45 (3)J1756 500 (3)J1786 680 (3)J1790 2 (3)J1800 6 (3)J1810 0 (3)J1815 8 (3)J1817 0 (3)J1826 1 (3)J1830 1 (3)J1833 372 (3)J1835 0 (3)J1840 3 (3)J1850 4 (3)J1885 8 (3)J1890 0 (3)J1930 120 (3)J1931 377 (3)J1940 6 (3)J1942 1064 (3)J1945 0 (3)J1950 12 (3)J1953 300 (3)J1955 11 (3)J1956 4 (3)J1960 0 (3)J1980 2 (3)J1990 0 (3)J2001 60 (3)J2010 10 (3)J2020 6 (3)J2060 4 (3)J2150 8 (3)J2170 8 (3)J2175 4 (3)J2180 0 (3)J2182 300 (3)J2185 30 (3)J2210 1 (3)J2212 240 (3)J2248 150 (3)J2250 22 (3)J2260 4 (3)J2265 400 (3)J2270 9 (3)J2274 250 (3)J2278 1000 (3)J2280 4 (3)J2300 4 (3)J2310 4 (3)J2315 380 (3)J2320 4 (3)J2323 300 (3)J2325 0 (3)J2326 120 (3)J2350 600 (3)J2353 60 (3)J2354 60 (3)
HCPCS MUEJ2355 2 (3)J2357 90 (3)J2358 405 (3)J2360 2 (3)J2370 2 (3)J2400 4 (3)J2405 64 (3)J2407 120 (3)J2410 2 (3)J2425 125 (3)J2426 819 (3)J2430 3 (3)J2440 4 (3)J2460 0 (3)J2469 10 (3)J2501 2 (3)J2502 60 (3)J2503 2 (3)J2504 15 (3)J2505 1 (3)J2507 8 (3)J2510 4 (3)J2513 1 (3)J2515 1 (3)J2540 75 (3)J2543 16 (3)J2545 1 (3)J2547 600 (3)J2550 3 (3)J2560 1 (3)J2562 48 (3)J2590 3 (3)J2597 45 (3)J2650 0 (3)J2670 0 (3)J2675 1 (3)J2680 4 (3)J2690 4 (3)J2700 48 (3)J2704 80 (3)J2710 2 (3)J2720 5 (3)J2724 3500 (3)J2725 0 (3)J2730 2 (3)J2760 2 (3)J2765 10 (3)J2770 6 (3)J2778 10 (3)J2780 16 (3)J2783 60 (3)J2785 4 (3)J2786 500 (3)J2788 1 (3)J2790 1 (3)J2791 50 (3)J2792 450 (3)J2793 320 (3)J2794 100 (3)J2795 200 (3)J2796 150 (3)J2800 3 (3)J2805 3 (3)J2810 5 (3)J2820 15 (3)
HCPCS MUEJ2840 160 (3)J2850 16 (3)J2860 170 (3)J2910 0 (3)J2916 20 (3)J2920 25 (3)J2930 25 (3)J2940 0 (3)J2941 8 (3)J2950 0 (3)J2993 2 (3)J2995 0 (3)J2997 8 (3)J3000 2 (3)J3010 100 (3)J3030 1 (3)J3060 760 (3)J3070 3 (3)J3090 200 (3)J3095 150 (3)J3101 50 (3)J3105 2 (3)J3110 2 (3)J3121 400 (3)J3145 750 (3)J3230 2 (3)J3240 1 (3)J3243 150 (3)J3246 1 (3)J3250 2 (3)J3260 8 (3)J3262 800 (3)J3265 0 (3)J3280 0 (3)J3285 1 (3)J3300 160 (3)J3301 16 (3)J3302 0 (3)J3303 24 (3)J3305 0 (3)J3310 0 (3)J3315 6 (3)J3320 0 (3)J3350 0 (3)J3355 1 (3)J3357 90 (3)J3358 520 (3)J3360 6 (3)J3364 0 (3)J3365 0 (3)J3370 12 (3)J3380 300 (3)J3385 80 (3)J3396 150 (3)J3400 0 (3)J3410 8 (3)J3411 4 (3)J3415 6 (3)J3420 1 (3)J3430 25 (3)J3465 40 (3)J3470 3 (3)J3471 999 (2)J3472 2 (3)J3473 450 (3)
HCPCS MUEJ3475 20 (3)J3480 40 (3)J3485 160 (3)J3486 4 (3)J3489 5 (3)J3520 0 (3)J3530 0 (3)J3535 0 (3)J3570 0 (3)J7030 5 (3)J7040 6 (3)J7042 6 (3)J7050 10 (3)J7060 10 (3)J7070 4 (3)J7100 2 (3)J7110 2 (3)J7120 4 (3)J7121 4 (3)J7131 500 (3)J7175 9000 (1)J7178 7700 (1)J7179 7500 (1)J7180 6000 (1)J7181 3850 (1)J7182 22000 (1)J7183 7500 (1)J7185 22000 (1)J7186 7500 (1)J7187 7500 (1)J7188 22000 (1)J7189 13000 (1)J7190 22000 (1)J7191 0 (3)J7192 22000 (1)J7193 4000 (1)J7194 9000 (1)J7195 6000 (1)J7196 175 (3)J7197 6300 (1)J7198 6000 (1)J7200 20000 (1)J7201 9000 (1)J7202 11550 (1)J7205 9750 (1)J7207 7500 (1)J7209 7500 (1)J7210 22000 (1)J7211 22000 (1)J7296 0 (3)J7297 0 (3)J7298 0 (3)J7300 0 (3)J7301 0 (3)J7303 0 (3)J7304 0 (3)J7306 0 (3)J7307 0 (3)J7308 3 (3)J7309 1 (3)J7310 0 (3)J7311 1 (3)J7312 14 (3)J7313 38 (3)J7315 2 (3)
HCPCS MUEJ7316 3 (2)J7320 50 (3)J7321 2 (2)J7322 48 (3)J7323 2 (2)J7324 2 (2)J7325 96 (3)J7326 2 (2)J7327 2 (2)J7328 336 (3)J7330 1 (3)J7336 1120 (3)J7340 1 (3)J7342 10 (3)J7345 200 (3)J7500 0 (3)J7501 1 (3)J7502 0 (3)J7503 0 (3)J7504 15 (3)J7505 1 (3)J7507 0 (3)J7508 0 (3)J7509 0 (3)J7510 0 (3)J7511 9 (3)J7512 0 (3)J7513 6 (3)J7515 0 (3)J7516 1 (3)J7517 0 (3)J7518 0 (3)J7520 0 (3)J7525 2 (3)J7527 0 (3)J7599 1 (3)J7604 0 (3)J7605 2 (3)J7606 2 (3)J7607 0 (3)J7608 3 (3)J7609 0 (3)J7610 0 (3)J7611 10 (3)J7612 10 (3)J7613 10 (3)J7614 10 (3)J7615 0 (3)J7620 6 (3)J7622 0 (3)J7624 0 (3)J7626 2 (3)J7627 0 (3)J7628 0 (3)J7629 0 (3)J7631 4 (3)J7632 0 (3)J7633 0 (3)J7634 0 (3)J7635 0 (3)J7636 0 (3)J7637 0 (3)J7638 0 (3)J7639 3 (3)J7640 0 (3)
HCPCS MUEJ7641 0 (3)J7642 0 (3)J7643 0 (3)J7644 3 (3)J7645 0 (3)J7647 0 (3)J7648 0 (3)J7649 0 (3)J7650 0 (3)J7657 0 (3)J7658 0 (3)J7659 0 (3)J7660 0 (3)J7665 0 (3)J7667 0 (3)J7668 0 (3)J7669 0 (3)J7670 0 (3)J7674 100 (3)J7676 0 (3)J7680 0 (3)J7681 0 (3)J7682 2 (3)J7683 0 (3)J7684 0 (3)J7685 0 (3)J7686 1 (3)J7699 1 (3)J7799 2 (3)J7999 2 (3)J8498 0 (3)J8499 0 (3)J8501 0 (3)J8510 0 (3)J8515 0 (3)J8520 0 (3)J8521 0 (3)J8530 0 (3)J8540 0 (3)J8560 0 (3)J8562 0 (3)J8565 0 (3)J8597 0 (3)J8600 0 (3)J8610 0 (3)J8650 0 (3)J8655 1 (3)J8670 0 (3)J8700 0 (3)J8705 0 (3)J8999 0 (3)J9000 20 (3)J9015 1 (3)J9017 30 (3)J9019 60 (3)J9020 0 (3)J9022 120 (3)J9023 160 (3)J9025 300 (3)J9027 100 (3)J9031 1 (3)J9032 300 (3)J9033 300 (3)J9034 360 (3)J9035 170 (3)
HCPCS MUEJ9039 210 (3)J9040 4 (3)J9041 35 (3)J9042 200 (3)J9043 60 (3)J9045 22 (3)J9047 160 (3)J9050 6 (3)J9055 120 (3)J9060 24 (3)J9065 100 (3)J9070 55 (3)J9098 5 (3)J9100 120 (3)J9120 5 (3)J9130 24 (3)J9145 240 (3)J9150 12 (3)J9151 10 (3)J9155 240 (3)J9160 7 (3)J9165 0 (3)J9171 240 (3)J9175 10 (3)J9176 3000 (3)J9178 150 (3)J9179 50 (3)J9181 100 (3)J9185 2 (3)J9190 20 (3)J9200 5 (3)J9201 20 (3)J9202 3 (3)J9203 180 (3)J9205 215 (3)J9206 42 (3)J9207 90 (3)J9208 15 (3)J9209 55 (3)J9211 6 (3)J9212 0 (3)J9213 12 (3)J9214 100 (3)J9215 0 (3)J9216 2 (3)J9217 6 (3)J9218 1 (3)J9219 1 (3)J9225 1 (3)J9226 1 (3)J9228 1100 (3)J9230 5 (3)J9245 9 (3)J9250 25 (3)J9260 20 (3)J9261 80 (3)J9262 700 (3)J9263 700 (3)J9264 600 (3)J9266 2 (3)J9267 750 (3)J9268 1 (3)J9270 0 (3)J9271 300 (3)J9280 12 (3)
HCPCS MUE
Medically Unlikely Edits (MUEs) 2019 HCPCS Level II
6 © 2018 Optum360, LLC
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J9285 250 (3)J9293 8 (3)J9295 800 (3)J9299 480 (3)J9301 100 (3)J9302 200 (3)J9303 90 (3)J9305 150 (3)J9306 840 (3)J9307 60 (3)J9308 280 (3)J9315 40 (3)J9320 4 (3)J9325 400 (3)J9328 400 (3)J9330 50 (3)J9340 4 (3)J9351 120 (3)J9352 40 (3)J9354 600 (3)J9355 100 (3)J9357 4 (3)J9360 45 (3)J9370 4 (3)J9371 5 (3)J9390 36 (3)J9395 20 (3)J9400 500 (3)J9600 4 (3)K0001 0 (3)K0002 0 (3)K0003 0 (3)K0004 0 (3)K0005 0 (3)K0006 0 (3)K0007 0 (3)K0008 0 (3)K0009 0 (3)K0010 0 (3)K0011 0 (3)K0012 0 (3)K0013 0 (3)K0014 0 (3)K0015 0 (3)K0017 0 (3)K0018 0 (3)K0019 0 (3)K0020 0 (3)K0037 0 (3)K0038 0 (3)K0039 0 (3)K0040 0 (3)K0041 0 (3)K0042 0 (3)K0043 0 (3)K0044 0 (3)K0045 0 (3)K0046 0 (3)K0047 0 (3)K0050 0 (3)K0051 0 (3)K0052 0 (3)K0053 0 (3)K0056 0 (3)K0065 0 (3)
HCPCS MUEK0069 0 (3)K0070 0 (3)K0071 0 (3)K0072 0 (3)K0073 0 (3)K0077 0 (3)K0098 0 (3)K0105 0 (3)K0108 0 (3)K0195 0 (3)K0455 0 (3)K0462 0 (3)K0553 0 (3)K0554 0 (3)K0602 0 (3)K0604 0 (3)K0605 0 (3)K0606 0 (3)K0607 0 (3)K0608 0 (3)K0609 0 (3)K0669 0 (3)K0672 0 (3)K0730 0 (3)K0733 0 (3)K0738 0 (3)K0740 0 (3)K0743 0 (3)K0744 0 (3)K0745 0 (3)K0746 0 (3)K0800 0 (3)K0801 0 (3)K0802 0 (3)K0806 0 (3)K0807 0 (3)K0808 0 (3)K0812 0 (3)K0813 0 (3)K0814 0 (3)K0815 0 (3)K0816 0 (3)K0820 0 (3)K0821 0 (3)K0822 0 (3)K0823 0 (3)K0824 0 (3)K0825 0 (3)K0826 0 (3)K0827 0 (3)K0828 0 (3)K0829 0 (3)K0830 0 (3)K0831 0 (3)K0835 0 (3)K0836 0 (3)K0837 0 (3)K0838 0 (3)K0839 0 (3)K0840 0 (3)K0841 0 (3)K0842 0 (3)K0843 0 (3)K0848 0 (3)K0849 0 (3)
HCPCS MUEK0850 0 (3)K0851 0 (3)K0852 0 (3)K0853 0 (3)K0854 0 (3)K0855 0 (3)K0856 0 (3)K0857 0 (3)K0858 0 (3)K0859 0 (3)K0860 0 (3)K0861 0 (3)K0862 0 (3)K0863 0 (3)K0864 0 (3)K0868 0 (3)K0869 0 (3)K0870 0 (3)K0871 0 (3)K0877 0 (3)K0878 0 (3)K0879 0 (3)K0880 0 (3)K0884 0 (3)K0885 0 (3)K0886 0 (3)K0890 0 (3)K0891 0 (3)K0898 1 (2)K0899 0 (3)K0900 0 (3)L0112 0 (3)L0113 0 (3)L0120 0 (3)L0130 0 (3)L0140 0 (3)L0150 0 (3)L0160 0 (3)L0170 0 (3)L0172 0 (3)L0174 0 (3)L0180 0 (3)L0190 0 (3)L0200 0 (3)L0220 0 (3)L0450 0 (3)L0452 0 (3)L0454 0 (3)L0455 0 (3)L0456 0 (3)L0457 0 (3)L0458 0 (3)L0460 0 (3)L0462 0 (3)L0464 0 (3)L0466 0 (3)L0467 0 (3)L0468 0 (3)L0469 0 (3)L0470 0 (3)L0472 0 (3)L0480 0 (3)L0482 0 (3)L0484 0 (3)L0486 0 (3)
HCPCS MUEL0488 0 (3)L0490 0 (3)L0491 0 (3)L0492 0 (3)L0621 0 (3)L0622 0 (3)L0623 0 (3)L0624 0 (3)L0625 0 (3)L0626 0 (3)L0627 0 (3)L0628 0 (3)L0629 0 (3)L0630 0 (3)L0631 0 (3)L0632 0 (3)L0633 0 (3)L0634 0 (3)L0635 0 (3)L0636 0 (3)L0637 0 (3)L0638 0 (3)L0639 0 (3)L0640 0 (3)L0641 0 (3)L0642 0 (3)L0643 0 (3)L0648 0 (3)L0649 0 (3)L0650 0 (3)L0651 0 (3)L0700 0 (3)L0710 0 (3)L0810 0 (3)L0820 0 (3)L0830 0 (3)L0859 0 (3)L0861 0 (3)L0970 0 (3)L0972 0 (3)L0974 0 (3)L0976 0 (3)L0978 0 (3)L0980 0 (3)L0982 0 (3)L0984 0 (3)L0999 0 (3)L1000 0 (3)L1001 0 (3)L1005 0 (3)L1010 0 (3)L1020 0 (3)L1025 0 (3)L1030 0 (3)L1040 0 (3)L1050 0 (3)L1060 0 (3)L1070 0 (3)L1080 0 (3)L1085 0 (3)L1090 0 (3)L1100 0 (3)L1110 0 (3)L1120 0 (3)L1200 0 (3)
HCPCS MUEL1210 0 (3)L1220 0 (3)L1230 0 (3)L1240 0 (3)L1250 0 (3)L1260 0 (3)L1270 0 (3)L1280 0 (3)L1290 0 (3)L1300 0 (3)L1310 0 (3)L1499 1 (3)L1600 0 (3)L1610 0 (3)L1620 0 (3)L1630 0 (3)L1640 0 (3)L1650 0 (3)L1652 0 (3)L1660 0 (3)L1680 0 (3)L1685 0 (3)L1686 0 (3)L1690 0 (3)L1700 0 (3)L1710 0 (3)L1720 0 (3)L1730 0 (3)L1755 0 (3)L1810 0 (3)L1812 0 (3)L1820 0 (3)L1830 0 (3)L1831 0 (3)L1832 0 (3)L1833 0 (3)L1834 0 (3)L1836 0 (3)L1840 0 (3)L1843 0 (3)L1844 0 (3)L1845 0 (3)L1846 0 (3)L1847 0 (3)L1848 0 (3)L1850 0 (3)L1851 0 (3)L1852 0 (3)L1860 0 (3)L1900 0 (3)L1902 0 (3)L1904 0 (3)L1906 0 (3)L1907 0 (3)L1910 0 (3)L1920 0 (3)L1930 0 (3)L1932 0 (3)L1940 0 (3)L1945 0 (3)L1950 0 (3)L1951 0 (3)L1960 0 (3)L1970 0 (3)L1971 0 (3)
HCPCS MUEL1980 0 (3)L1990 0 (3)L2000 0 (3)L2005 0 (3)L2010 0 (3)L2020 0 (3)L2030 0 (3)L2034 0 (3)L2035 0 (3)L2036 0 (3)L2037 0 (3)L2038 0 (3)L2040 0 (3)L2050 0 (3)L2060 0 (3)L2070 0 (3)L2080 0 (3)L2090 0 (3)L2106 0 (3)L2108 0 (3)L2112 0 (3)L2114 0 (3)L2116 0 (3)L2126 0 (3)L2128 0 (3)L2132 0 (3)L2134 0 (3)L2136 0 (3)L2180 0 (3)L2182 0 (3)L2184 0 (3)L2186 0 (3)L2188 0 (3)L2190 0 (3)L2192 0 (3)L2200 0 (3)L2210 0 (3)L2220 0 (3)L2230 0 (3)L2232 0 (3)L2240 0 (3)L2250 0 (3)L2260 0 (3)L2265 0 (3)L2270 0 (3)L2275 0 (3)L2280 0 (3)L2300 0 (3)L2310 0 (3)L2320 0 (3)L2330 0 (3)L2335 0 (3)L2340 0 (3)L2350 0 (3)L2360 0 (3)L2370 0 (3)L2375 0 (3)L2380 0 (3)L2385 0 (3)L2387 0 (3)L2390 0 (3)L2395 0 (3)L2397 0 (3)L2405 0 (3)L2415 0 (3)
HCPCS MUEL2425 0 (3)L2430 0 (3)L2492 0 (3)L2500 0 (3)L2510 0 (3)L2520 0 (3)L2525 0 (3)L2526 0 (3)L2530 0 (3)L2540 0 (3)L2550 0 (3)L2570 0 (3)L2580 0 (3)L2600 0 (3)L2610 0 (3)L2620 0 (3)L2622 0 (3)L2624 0 (3)L2627 0 (3)L2628 0 (3)L2630 0 (3)L2640 0 (3)L2650 0 (3)L2660 0 (3)L2670 0 (3)L2680 0 (3)L2750 0 (3)L2755 0 (3)L2760 0 (3)L2768 0 (3)L2780 0 (3)L2785 0 (3)L2795 0 (3)L2800 0 (3)L2810 0 (3)L2820 0 (3)L2830 0 (3)L2840 0 (3)L2850 0 (3)L2861 0 (3)L2999 0 (3)L3000 0 (3)L3001 0 (3)L3002 0 (3)L3003 0 (3)L3010 0 (3)L3020 0 (3)L3030 0 (3)L3031 0 (3)L3040 0 (3)L3050 0 (3)L3060 0 (3)L3070 0 (3)L3080 0 (3)L3090 0 (3)L3100 0 (3)L3140 0 (3)L3150 0 (3)L3160 0 (3)L3170 0 (3)L3201 0 (3)L3202 0 (3)L3203 0 (3)L3204 0 (3)L3206 0 (3)
HCPCS MUEL3207 0 (3)L3208 0 (3)L3209 0 (3)L3211 0 (3)L3212 0 (3)L3213 0 (3)L3214 0 (3)L3215 0 (3)L3216 0 (3)L3217 0 (3)L3219 0 (3)L3221 0 (3)L3222 0 (3)L3224 0 (3)L3225 0 (3)L3230 0 (3)L3250 0 (3)L3251 0 (3)L3252 0 (3)L3253 0 (3)L3254 0 (3)L3255 0 (3)L3257 0 (3)L3260 0 (3)L3265 0 (3)L3300 0 (3)L3310 0 (3)L3320 0 (3)L3330 0 (3)L3332 0 (3)L3334 0 (3)L3340 0 (3)L3350 0 (3)L3360 0 (3)L3370 0 (3)L3380 0 (3)L3390 0 (3)L3400 0 (3)L3410 0 (3)L3420 0 (3)L3430 0 (3)L3440 0 (3)L3450 0 (3)L3455 0 (3)L3460 0 (3)L3465 0 (3)L3470 0 (3)L3480 0 (3)L3485 0 (3)L3500 0 (3)L3510 0 (3)L3520 0 (3)L3530 0 (3)L3540 0 (3)L3550 0 (3)L3560 0 (3)L3570 0 (3)L3580 0 (3)L3590 0 (3)L3595 0 (3)L3600 0 (3)L3610 0 (3)L3620 0 (3)L3630 0 (3)L3640 0 (3)
HCPCS MUE
2019 HCPCS Level II Medically Unlikely Edits (MUEs)
© 2018 Optum360, LLC 7
Medically U
nlikely Edits (MU
Es)—Professional
L3649 0 (3)L3650 0 (3)L3660 0 (3)L3670 0 (3)L3671 0 (3)L3674 0 (3)L3675 0 (3)L3677 0 (3)L3678 0 (3)L3702 0 (3)L3710 0 (3)L3720 0 (3)L3730 0 (3)L3740 0 (3)L3760 0 (3)L3761 0 (3)L3762 0 (3)L3763 0 (3)L3764 0 (3)L3765 0 (3)L3766 0 (3)L3806 0 (3)L3807 0 (3)L3808 0 (3)L3809 0 (3)L3891 0 (3)L3900 0 (3)L3901 0 (3)L3904 0 (3)L3905 0 (3)L3906 0 (3)L3908 0 (3)L3912 0 (3)L3913 0 (3)L3915 0 (3)L3916 0 (3)L3917 0 (3)L3918 0 (3)L3919 0 (3)L3921 0 (3)L3923 0 (3)L3924 0 (3)L3925 0 (3)L3927 0 (3)L3929 0 (3)L3930 0 (3)L3931 0 (3)L3933 0 (3)L3935 0 (3)L3956 0 (3)L3960 0 (3)L3961 0 (3)L3962 0 (3)L3967 0 (3)L3971 0 (3)L3973 0 (3)L3975 0 (3)L3976 0 (3)L3977 0 (3)L3978 0 (3)L3980 0 (3)L3981 0 (3)L3982 0 (3)L3984 0 (3)L3995 0 (3)
HCPCS MUEL3999 0 (3)L4000 0 (3)L4002 0 (3)L4010 0 (3)L4020 0 (3)L4030 0 (3)L4040 0 (3)L4045 0 (3)L4050 0 (3)L4055 0 (3)L4060 0 (3)L4070 0 (3)L4080 0 (3)L4090 0 (3)L4100 0 (3)L4110 0 (3)L4130 0 (3)L4205 0 (3)L4210 0 (3)L4350 0 (3)L4360 0 (3)L4361 0 (3)L4370 0 (3)L4386 0 (3)L4387 0 (3)L4392 0 (3)L4394 0 (3)L4396 0 (3)L4397 0 (3)L4398 0 (3)L4631 0 (3)L5000 0 (3)L5010 0 (3)L5020 0 (3)L5050 0 (3)L5060 0 (3)L5100 0 (3)L5105 0 (3)L5150 0 (3)L5160 0 (3)L5200 0 (3)L5210 0 (3)L5220 0 (3)L5230 0 (3)L5250 0 (3)L5270 0 (3)L5280 0 (3)L5301 0 (3)L5312 0 (3)L5321 0 (3)L5331 0 (3)L5341 0 (3)L5400 0 (3)L5410 0 (3)L5420 0 (3)L5430 0 (3)L5450 0 (3)L5460 0 (3)L5500 0 (3)L5505 0 (3)L5510 0 (3)L5520 0 (3)L5530 0 (3)L5535 0 (3)L5540 0 (3)
HCPCS MUEL5560 0 (3)L5570 0 (3)L5580 0 (3)L5585 0 (3)L5590 0 (3)L5595 0 (3)L5600 0 (3)L5610 0 (3)L5611 0 (3)L5613 0 (3)L5614 0 (3)L5616 0 (3)L5617 0 (3)L5618 0 (3)L5620 0 (3)L5622 0 (3)L5624 0 (3)L5626 0 (3)L5628 0 (3)L5629 0 (3)L5630 0 (3)L5631 0 (3)L5632 0 (3)L5634 0 (3)L5636 0 (3)L5637 0 (3)L5638 0 (3)L5639 0 (3)L5640 0 (3)L5642 0 (3)L5643 0 (3)L5644 0 (3)L5645 0 (3)L5646 0 (3)L5647 0 (3)L5648 0 (3)L5649 0 (3)L5650 0 (3)L5651 0 (3)L5652 0 (3)L5653 0 (3)L5654 0 (3)L5655 0 (3)L5656 0 (3)L5658 0 (3)L5661 0 (3)L5665 0 (3)L5666 0 (3)L5668 0 (3)L5670 0 (3)L5671 0 (3)L5672 0 (3)L5673 0 (3)L5676 0 (3)L5677 0 (3)L5678 0 (3)L5679 0 (3)L5680 0 (3)L5681 0 (3)L5682 0 (3)L5683 0 (3)L5684 0 (3)L5685 0 (3)L5686 0 (3)L5688 0 (3)
HCPCS MUEL5690 0 (3)L5692 0 (3)L5694 0 (3)L5695 0 (3)L5696 0 (3)L5697 0 (3)L5698 0 (3)L5699 0 (3)L5700 0 (3)L5701 0 (3)L5702 0 (3)L5703 0 (3)L5704 0 (3)L5705 0 (3)L5706 0 (3)L5707 0 (3)L5710 0 (3)L5711 0 (3)L5712 0 (3)L5714 0 (3)L5716 0 (3)L5718 0 (3)L5722 0 (3)L5724 0 (3)L5726 0 (3)L5728 0 (3)L5780 0 (3)L5781 0 (3)L5782 0 (3)L5785 0 (3)L5790 0 (3)L5795 0 (3)L5810 0 (3)L5811 0 (3)L5812 0 (3)L5814 0 (3)L5816 0 (3)L5818 0 (3)L5822 0 (3)L5824 0 (3)L5826 0 (3)L5828 0 (3)L5830 0 (3)L5840 0 (3)L5845 0 (3)L5848 0 (3)L5850 0 (3)L5855 0 (3)L5856 0 (3)L5857 0 (3)L5858 0 (3)L5859 0 (3)L5910 0 (3)L5920 0 (3)L5925 0 (3)L5930 0 (3)L5940 0 (3)L5950 0 (3)L5960 0 (3)L5961 0 (3)L5962 0 (3)L5964 0 (3)L5966 0 (3)L5968 0 (3)L5969 0 (3)
HCPCS MUEL5970 0 (3)L5971 0 (3)L5972 0 (3)L5973 0 (3)L5974 0 (3)L5975 0 (3)L5976 0 (3)L5978 0 (3)L5979 0 (3)L5980 0 (3)L5981 0 (3)L5982 0 (3)L5984 0 (3)L5985 0 (3)L5986 0 (3)L5987 0 (3)L5988 0 (3)L5990 0 (3)L5999 0 (3)L6000 0 (3)L6010 0 (3)L6020 0 (3)L6026 0 (3)L6050 0 (3)L6055 0 (3)L6100 0 (3)L6110 0 (3)L6120 0 (3)L6130 0 (3)L6200 0 (3)L6205 0 (3)L6250 0 (3)L6300 0 (3)L6310 0 (3)L6320 0 (3)L6350 0 (3)L6360 0 (3)L6370 0 (3)L6380 0 (3)L6382 0 (3)L6384 0 (3)L6386 0 (3)L6388 0 (3)L6400 0 (3)L6450 0 (3)L6500 0 (3)L6550 0 (3)L6570 0 (3)L6580 0 (3)L6582 0 (3)L6584 0 (3)L6586 0 (3)L6588 0 (3)L6590 0 (3)L6600 0 (3)L6605 0 (3)L6610 0 (3)L6611 0 (3)L6615 0 (3)L6616 0 (3)L6620 0 (3)L6621 0 (3)L6623 0 (3)L6624 0 (3)L6625 0 (3)
HCPCS MUEL6628 0 (3)L6629 0 (3)L6630 0 (3)L6632 0 (3)L6635 0 (3)L6637 0 (3)L6638 0 (3)L6640 0 (3)L6641 0 (3)L6642 0 (3)L6645 0 (3)L6646 0 (3)L6647 0 (3)L6648 0 (3)L6650 0 (3)L6655 0 (3)L6660 0 (3)L6665 0 (3)L6670 0 (3)L6672 0 (3)L6675 0 (3)L6676 0 (3)L6677 0 (3)L6680 0 (3)L6682 0 (3)L6684 0 (3)L6686 0 (3)L6687 0 (3)L6688 0 (3)L6689 0 (3)L6690 0 (3)L6691 0 (3)L6692 0 (3)L6693 0 (3)L6694 0 (3)L6695 0 (3)L6696 0 (3)L6697 0 (3)L6698 0 (3)L6703 0 (3)L6704 0 (3)L6706 0 (3)L6707 0 (3)L6708 0 (3)L6709 0 (3)L6711 0 (3)L6712 0 (3)L6713 0 (3)L6714 0 (3)L6715 0 (3)L6721 0 (3)L6722 0 (3)L6805 0 (3)L6810 0 (3)L6880 0 (3)L6881 0 (3)L6882 0 (3)L6883 0 (3)L6884 0 (3)L6885 0 (3)L6890 0 (3)L6895 0 (3)L6900 0 (3)L6905 0 (3)L6910 0 (3)
HCPCS MUEL6915 0 (3)L6920 0 (3)L6925 0 (3)L6930 0 (3)L6935 0 (3)L6940 0 (3)L6945 0 (3)L6950 0 (3)L6955 0 (3)L6960 0 (3)L6965 0 (3)L6970 0 (3)L6975 0 (3)L7007 0 (3)L7008 0 (3)L7009 0 (3)L7040 0 (3)L7045 0 (3)L7170 0 (3)L7180 0 (3)L7181 0 (3)L7185 0 (3)L7186 0 (3)L7190 0 (3)L7191 0 (3)L7259 0 (3)L7360 0 (3)L7362 0 (3)L7364 0 (3)L7366 0 (3)L7367 0 (3)L7368 0 (3)L7400 0 (3)L7401 0 (3)L7402 0 (3)L7403 0 (3)L7404 0 (3)L7405 0 (3)L7499 0 (3)L7510 4 (3)L7600 0 (3)L7700 0 (3)L7900 0 (3)L7902 0 (3)L8000 0 (3)L8001 0 (3)L8002 0 (3)L8010 0 (3)L8015 0 (3)L8020 0 (3)L8030 0 (3)L8031 0 (3)L8032 0 (3)L8035 0 (3)L8039 0 (3)L8040 0 (3)L8041 0 (3)L8042 0 (3)L8043 0 (3)L8044 0 (3)L8045 0 (3)L8046 0 (3)L8047 0 (3)L8048 1 (3)L8049 0 (3)
HCPCS MUEL8300 0 (3)L8310 0 (3)L8320 0 (3)L8330 0 (3)L8400 0 (3)L8410 0 (3)L8415 0 (3)L8417 0 (3)L8420 0 (3)L8430 0 (3)L8435 0 (3)L8440 0 (3)L8460 0 (3)L8465 0 (3)L8470 0 (3)L8480 0 (3)L8485 0 (3)L8499 1 (3)L8500 0 (3)L8501 0 (3)L8505 0 (3)L8507 0 (3)L8509 1 (3)L8510 0 (3)L8511 1 (3)L8512 1 (3)L8513 1 (3)L8514 1 (3)L8515 1 (3)L8600 2 (3)L8603 4 (3)L8604 3 (3)L8605 4 (3)L8606 5 (3)L8607 20 (3)L8609 1 (3)L8610 1 (3)L8612 1 (3)L8613 1 (3)L8614 1 (3)L8615 2 (3)L8616 2 (3)L8617 2 (3)L8618 2 (3)L8619 2 (3)L8621 360 (3)L8622 2 (3)L8625 1 (3)L8627 2 (2)L8628 2 (2)L8629 2 (2)L8631 1 (3)L8641 4 (3)L8642 2 (3)L8658 2 (3)L8659 2 (3)L8670 2 (3)L8679 1 (3)L8681 1 (3)L8682 2 (3)L8683 1 (3)L8684 1 (3)L8685 1 (3)L8686 2 (3)L8687 1 (3)
HCPCS MUE
Medically Unlikely Edits (MUEs) 2019 HCPCS Level II
8 © 2018 Optum360, LLC
Med
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Edit
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)—Pr
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L8688 1 (3)L8689 1 (3)L8690 2 (2)L8691 1 (3)L8692 0 (3)L8693 1 (3)L8694 1 (3)L8695 1 (3)L8696 1 (3)M0075 0 (3)M0076 0 (3)M0100 0 (3)M0300 0 (3)M0301 0 (3)P2028 1 (2)P2029 1 (2)P2031 0 (3)P2033 1 (2)P2038 1 (2)P3000 1 (3)P3001 1 (3)P7001 0 (3)P9010 2 (3)P9011 2 (3)P9012 8 (3)P9016 3 (3)P9017 2 (3)P9019 2 (3)P9020 2 (3)P9021 3 (3)P9022 2 (3)P9023 2 (3)P9031 12 (3)P9032 12 (3)P9033 12 (3)P9034 2 (3)P9035 2 (3)P9036 2 (3)P9037 2 (3)P9038 2 (3)P9039 2 (3)P9040 3 (3)P9041 5 (3)P9043 5 (3)P9044 10 (3)P9045 20 (3)P9046 25 (3)P9047 20 (3)P9048 1 (3)P9050 1 (3)P9051 2 (3)P9052 2 (3)P9053 2 (3)P9054 2 (3)P9055 2 (3)P9056 2 (3)P9057 2 (3)P9058 2 (3)
HCPCS MUEP9059 2 (3)P9060 2 (3)P9070 2 (3)P9071 2 (3)P9073 2 (3)P9100 2 (3)P9603 300 (3)P9604 2 (3)P9612 1 (3)P9615 1 (3)Q0035 1 (3)Q0081 1 (3)Q0083 1 (3)Q0084 1 (3)Q0085 1 (3)Q0091 1 (3)Q0111 2 (3)Q0112 3 (3)Q0113 1 (3)Q0114 1 (3)Q0115 1 (3)Q0138 510 (3)Q0139 510 (3)Q0144 0 (3)Q0161 0 (3)Q0162 0 (3)Q0163 0 (3)Q0164 0 (3)Q0166 0 (3)Q0167 0 (3)Q0169 0 (3)Q0173 0 (3)Q0174 0 (3)Q0175 0 (3)Q0177 0 (3)Q0180 0 (3)Q0181 0 (3)Q0477 1 (1)Q0478 1 (3)Q0479 1 (3)Q0480 1 (3)Q0481 1 (2)Q0482 1 (3)Q0483 1 (3)Q0484 1 (3)Q0485 1 (3)Q0486 1 (3)Q0487 1 (3)Q0488 1 (3)Q0489 1 (3)Q0490 1 (3)Q0491 1 (3)Q0492 1 (3)Q0493 1 (3)Q0494 1 (3)Q0495 1 (3)Q0496 1 (3)Q0497 2 (3)
HCPCS MUEQ0498 1 (3)Q0499 1 (3)Q0501 1 (3)Q0502 1 (3)Q0503 3 (3)Q0504 1 (3)Q0506 8 (3)Q0507 1 (3)Q0508 4 (3)Q0509 2 (3)Q0510 0 (3)Q0511 0 (3)Q0512 0 (3)Q0513 0 (3)Q0514 0 (3)Q0515 0 (3)Q1004 2 (2)Q1005 2 (2)Q2004 1 (3)Q2009 100 (3)Q2017 12 (3)Q2026 45 (3)Q2028 1470 (3)Q2034 1 (2)Q2035 1 (2)Q2036 1 (2)Q2037 1 (2)Q2038 1 (2)Q2039 1 (2)Q2043 1 (2)Q2049 14 (3)Q2050 14 (3)Q2052 1 (3)Q3014 1 (3)Q3027 30 (3)Q3028 0 (3)Q3031 1 (3)Q4001 1 (3)Q4002 1 (3)Q4003 2 (3)Q4004 2 (3)Q4025 1 (3)Q4026 1 (3)Q4027 1 (3)Q4028 1 (3)Q4050 2 (3)Q4051 2 (3)Q4074 3 (3)Q4081 100 (3)Q4101 88 (3)Q4102 21 (3)Q4103 0 (3)Q4104 50 (3)Q4105 250 (3)Q4106 76 (3)Q4107 50 (3)Q4108 250 (3)Q4110 250 (3)
HCPCS MUEQ4111 56 (3)Q4112 2 (3)Q4113 4 (3)Q4114 6 (3)Q4115 240 (3)Q4116 192 (3)Q4117 200 (3)Q4118 1000 (3)Q4121 116 (3)Q4122 96 (3)Q4123 160 (3)Q4124 140 (3)Q4125 28 (3)Q4126 32 (3)Q4127 100 (3)Q4128 192 (3)Q4130 100 (3)Q4132 50 (3)Q4133 113 (3)Q4134 160 (3)Q4135 900 (3)Q4136 900 (3)Q4137 32 (3)Q4138 32 (3)Q4139 2 (3)Q4140 32 (3)Q4141 25 (3)Q4142 600 (3)Q4143 96 (3)Q4145 160 (3)Q4146 50 (3)Q4147 150 (3)Q4148 24 (3)Q4149 10 (3)Q4150 32 (3)Q4151 60 (3)Q4152 24 (3)Q4153 6 (3)Q4154 36 (3)Q4155 100 (3)Q4156 49 (3)Q4157 24 (3)Q4158 70 (3)Q4159 28 (3)Q4160 36 (3)Q4161 42 (3)Q4162 4 (3)Q4163 32 (3)Q4164 400 (3)Q4165 100 (3)Q4166 100 (3)Q4167 32 (3)Q4168 160 (3)Q4169 32 (3)Q4170 120 (3)Q4171 100 (3)Q4173 64 (3)Q4174 8 (3)
HCPCS MUEQ4175 120 (3)Q5101 1500 (3)Q5103 150 (3)Q5104 150 (3)Q5105 100 (3)Q5106 60 (3)Q5108 12 (3)Q9950 5 (3)Q9951 0 (3)Q9953 10 (3)Q9954 18 (3)Q9955 0 (3)Q9956 9 (3)Q9957 3 (3)Q9958 300 (3)Q9959 0 (3)Q9960 250 (3)Q9961 200 (3)Q9962 150 (3)Q9963 240 (3)Q9964 0 (3)Q9966 250 (3)Q9967 300 (3)Q9969 3 (3)Q9982 1 (3)Q9983 1 (3)Q9991 1 (3)Q9992 1 (3)R0070 2 (3)R0075 2 (3)R0076 1 (3)V2020 0 (3)V2025 0 (3)V2100 0 (3)V2101 0 (3)V2102 0 (3)V2103 0 (3)V2104 0 (3)V2105 0 (3)V2106 0 (3)V2107 0 (3)V2108 0 (3)V2109 0 (3)V2110 0 (3)V2111 0 (3)V2112 0 (3)V2113 0 (3)V2114 0 (3)V2115 0 (3)V2118 0 (3)V2121 0 (3)V2199 2 (3)V2200 0 (3)V2201 0 (3)V2202 0 (3)V2203 0 (3)V2204 0 (3)V2205 0 (3)
HCPCS MUEV2206 0 (3)V2207 0 (3)V2208 0 (3)V2209 0 (3)V2210 0 (3)V2211 0 (3)V2212 0 (3)V2213 0 (3)V2214 0 (3)V2215 0 (3)V2218 0 (3)V2219 0 (3)V2220 0 (3)V2221 0 (3)V2299 0 (3)V2300 0 (3)V2301 0 (3)V2302 0 (3)V2303 0 (3)V2304 0 (3)V2305 0 (3)V2306 0 (3)V2307 0 (3)V2308 0 (3)V2309 0 (3)V2310 0 (3)V2311 0 (3)V2312 0 (3)V2313 0 (3)V2314 0 (3)V2315 0 (3)V2318 0 (3)V2319 0 (3)V2320 0 (3)V2321 0 (3)V2399 0 (3)V2410 0 (3)V2430 0 (3)V2499 2 (3)V2500 0 (3)V2501 0 (3)V2502 0 (3)V2503 0 (3)V2510 0 (3)V2511 0 (3)V2512 0 (3)V2513 0 (3)V2520 2 (3)V2521 2 (3)V2522 2 (3)V2523 2 (3)V2530 0 (3)V2531 0 (3)V2599 2 (3)V2600 0 (2)V2610 0 (2)V2615 0 (2)V2623 0 (3)
HCPCS MUEV2624 0 (3)V2625 0 (3)V2626 0 (3)V2627 0 (3)V2628 0 (3)V2629 0 (3)V2630 2 (2)V2631 2 (2)V2632 2 (2)V2700 0 (3)V2702 0 (3)V2710 0 (3)V2715 0 (3)V2718 0 (3)V2730 0 (3)V2744 0 (3)V2745 0 (3)V2750 0 (3)V2755 0 (3)V2756 0 (3)V2760 0 (3)V2761 0 (2)V2762 0 (3)V2770 0 (3)V2780 0 (3)V2781 0 (2)V2782 0 (3)V2783 0 (3)V2784 0 (3)V2785 2 (2)V2786 0 (3)V2787 0 (3)V2788 0 (3)V2790 1 (3)V2797 0 (3)V5008 0 (3)V5010 0 (3)V5011 0 (3)V5014 0 (3)V5020 0 (3)V5030 0 (3)V5040 0 (3)V5050 0 (3)V5060 0 (3)V5070 0 (3)V5080 0 (3)V5090 0 (3)V5095 0 (3)V5100 0 (3)V5110 0 (3)V5120 0 (3)V5130 0 (3)V5140 0 (3)V5150 0 (3)V5160 0 (3)V5190 0 (3)V5200 0 (3)V5230 0 (3)
HCPCS MUEV5240 0 (3)V5241 0 (3)V5242 0 (3)V5243 0 (3)V5244 0 (3)V5245 0 (3)V5246 0 (3)V5247 0 (3)V5248 0 (3)V5249 0 (3)V5250 0 (3)V5251 0 (3)V5252 0 (3)V5253 0 (3)V5254 0 (3)V5255 0 (3)V5256 0 (3)V5257 0 (3)V5258 0 (3)V5259 0 (3)V5260 0 (3)V5261 0 (3)V5262 0 (3)V5263 0 (3)V5264 0 (3)V5265 0 (3)V5266 0 (3)V5267 0 (3)V5268 0 (3)V5269 0 (3)V5270 0 (3)V5271 0 (3)V5272 0 (3)V5273 0 (3)V5274 0 (3)V5275 0 (3)V5281 0 (3)V5282 0 (3)V5283 0 (3)V5284 0 (3)V5285 0 (3)V5286 0 (3)V5287 0 (3)V5288 0 (3)V5289 0 (3)V5290 0 (3)V5298 0 (3)V5299 1 (3)V5336 0 (3)V5362 0 (3)V5363 0 (3)V5364 0 (3)
HCPCS MUE
2019 HCPCS Level II Medically Unlikely Edits (MUEs)
© 2018 Optum360, LLC 9
Medically U
nlikely Edits (MU
Es)—O
PPS
OPPS
HCPCS MUEA0021 0 (3)A0080 0 (3)A0090 0 (3)A0100 0 (3)A0110 0 (3)A0120 0 (3)A0130 0 (3)A0140 0 (3)A0160 0 (3)A0170 0 (3)A0180 0 (3)A0190 0 (3)A0200 0 (3)A0210 0 (3)A0225 0 (3)A0380 0 (3)A0382 0 (3)A0384 0 (3)A0390 0 (3)A0392 0 (3)A0394 0 (3)A0396 0 (3)A0398 0 (3)A0420 0 (3)A0422 0 (3)A0424 0 (3)A0425 250 (1)A0426 2 (3)A0427 2 (3)A0428 4 (3)A0429 2 (3)A0430 1 (3)A0431 1 (3)A0432 1 (3)A0433 1 (3)A0434 2 (3)A0435 999 (3)A0436 300 (3)A0888 0 (3)A0998 0 (3)A0999 1 (3)A4206 1 (3)A4207 1 (3)A4208 4 (3)A4209 6 (3)A4210 0 (3)A4211 1 (3)A4212 2 (3)A4213 5 (3)A4215 9 (3)A4216 25 (3)A4217 4 (3)A4218 20 (3)A4220 1 (3)A4221 1 (3)A4222 2 (3)A4223 1 (3)A4224 1 (2)A4225 1 (3)A4230 1 (3)A4231 1 (3)A4232 0 (3)A4233 0 (3)A4234 0 (3)
A4235 1 (3)A4236 0 (3)A4244 1 (3)A4245 1 (3)A4246 1 (3)A4247 1 (3)A4248 10 (3)A4250 0 (3)A4252 0 (3)A4253 0 (3)A4255 0 (3)A4256 1 (3)A4257 0 (3)A4258 0 (3)A4259 0 (3)A4261 0 (3)A4262 4 (2)A4263 4 (2)A4264 0 (3)A4265 1 (3)A4266 0 (3)A4267 0 (3)A4268 0 (3)A4269 0 (3)A4270 3 (3)A4280 1 (3)A4281 0 (3)A4282 0 (3)A4283 0 (3)A4284 0 (3)A4285 0 (3)A4286 0 (3)A4290 2 (3)A4300 4 (3)A4301 1 (2)A4305 2 (3)A4306 2 (3)A4310 2 (3)A4311 2 (3)A4312 1 (3)A4313 1 (3)A4314 2 (3)A4315 2 (3)A4316 1 (3)A4320 2 (3)A4321 1 (3)A4322 2 (3)A4326 1 (3)A4327 2 (3)A4328 1 (3)A4330 1 (3)A4331 3 (3)A4332 2 (3)A4335 1 (3)A4336 1 (3)A4337 2 (3)A4338 3 (3)A4340 2 (3)A4344 2 (3)A4346 2 (3)A4351 2 (3)A4352 2 (3)A4353 3 (3)A4354 2 (3)
HCPCS MUEA4355 2 (3)A4356 2 (3)A4357 2 (3)A4360 1 (3)A4361 1 (3)A4362 2 (3)A4363 0 (3)A4364 2 (3)A4366 1 (3)A4367 1 (3)A4368 1 (3)A4369 1 (3)A4371 1 (3)A4372 1 (3)A4373 1 (3)A4375 2 (3)A4376 2 (3)A4377 2 (3)A4378 2 (3)A4379 2 (3)A4380 2 (3)A4381 2 (3)A4382 2 (3)A4383 2 (3)A4384 2 (3)A4385 2 (3)A4387 1 (3)A4388 1 (3)A4389 2 (3)A4390 1 (3)A4391 1 (3)A4392 2 (3)A4393 1 (3)A4394 1 (3)A4395 3 (3)A4396 2 (3)A4397 1 (3)A4398 2 (3)A4399 1 (3)A4400 1 (3)A4402 1 (3)A4404 1 (3)A4405 1 (3)A4406 1 (3)A4407 2 (3)A4408 1 (3)A4409 1 (3)A4410 2 (3)A4411 1 (3)A4412 1 (3)A4413 2 (3)A4414 1 (3)A4415 1 (3)A4416 2 (3)A4417 2 (3)A4418 2 (3)A4419 2 (3)A4420 1 (3)A4423 2 (3)A4424 1 (3)A4425 1 (3)A4426 2 (3)A4427 1 (3)A4428 1 (3)
HCPCS MUEA4429 2 (3)A4430 1 (3)A4431 1 (3)A4432 2 (3)A4433 1 (3)A4434 1 (3)A4435 2 (3)A4450 20 (3)A4452 4 (3)A4455 1 (3)A4458 1 (3)A4459 1 (3)A4461 2 (3)A4463 2 (3)A4465 1 (3)A4467 0 (3)A4470 1 (3)A4480 1 (3)A4481 2 (3)A4483 1 (3)A4490 0 (3)A4495 0 (3)A4500 0 (3)A4510 0 (3)A4520 0 (3)A4550 3 (3)A4553 0 (3)A4554 0 (3)A4555 0 (3)A4556 2 (3)A4557 2 (3)A4558 1 (3)A4559 1 (3)A4561 1 (3)A4562 1 (3)A4565 2 (3)A4566 0 (3)A4570 0 (3)A4575 0 (3)A4580 0 (3)A4590 0 (3)A4595 2 (3)A4600 0 (3)A4601 0 (3)A4602 1 (3)A4604 1 (3)A4605 1 (3)A4606 1 (3)A4608 1 (3)A4611 0 (3)A4612 0 (3)A4613 0 (3)A4614 1 (2)A4615 2 (3)A4616 1 (3)A4617 1 (3)A4618 1 (3)A4619 1 (3)A4620 1 (3)A4623 10 (3)A4624 2 (3)A4625 30 (3)A4626 1 (3)A4627 0 (3)
HCPCS MUEA4628 1 (3)A4629 1 (3)A4630 0 (3)A4633 0 (3)A4634 1 (3)A4635 0 (3)A4636 0 (3)A4637 0 (3)A4638 0 (3)A4639 0 (3)A4640 0 (3)A4642 1 (3)A4648 3 (3)A4650 3 (3)A4651 2 (3)A4652 2 (3)A4653 0 (3)A4657 0 (3)A4660 0 (3)A4663 0 (3)A4670 0 (3)A4671 0 (3)A4672 0 (3)A4673 0 (3)A4674 0 (3)A4680 0 (3)A4690 0 (3)A4706 0 (3)A4707 0 (3)A4708 0 (3)A4709 0 (3)A4714 0 (3)A4719 0 (3)A4720 0 (3)A4721 0 (3)A4722 0 (3)A4723 0 (3)A4724 0 (3)A4725 0 (3)A4726 0 (3)A4728 0 (3)A4730 0 (3)A4736 0 (3)A4737 0 (3)A4740 0 (3)A4750 0 (3)A4755 0 (3)A4760 0 (3)A4765 0 (3)A4766 0 (3)A4770 0 (3)A4771 0 (3)A4772 0 (3)A4773 0 (3)A4774 0 (3)A4802 0 (3)A4860 0 (3)A4870 0 (3)A4890 0 (3)A4911 0 (3)A4913 0 (3)A4918 0 (3)A4927 0 (3)A4928 0 (3)
HCPCS MUEA4929 0 (3)A4930 0 (3)A4931 0 (3)A4932 0 (3)A5051 1 (3)A5052 1 (3)A5053 2 (3)A5054 1 (3)A5055 1 (3)A5056 90 (3)A5057 90 (3)A5061 2 (3)A5062 1 (3)A5063 1 (3)A5071 2 (3)A5072 1 (3)A5073 1 (3)A5081 2 (3)A5082 1 (3)A5083 5 (3)A5093 2 (3)A5102 1 (3)A5105 1 (3)A5112 2 (3)A5113 0 (3)A5114 0 (3)A5120 150 (3)A5121 1 (3)A5122 1 (3)A5126 2 (3)A5131 1 (3)A5200 2 (3)A5500 0 (3)A5501 0 (3)A5503 0 (3)A5504 0 (3)A5505 0 (3)A5506 0 (3)A5507 0 (3)A5508 0 (3)A5510 0 (3)A5512 0 (3)A5513 0 (3)A6000 0 (3)A6010 3 (3)A6011 20 (3)A6024 1 (3)A6025 4 (3)A6154 1 (3)A6205 1 (3)A6221 9 (3)A6228 2 (3)A6230 1 (3)A6236 1 (3)A6238 3 (3)A6239 1 (3)A6240 2 (3)A6241 1 (3)A6244 1 (3)A6246 3 (3)A6247 2 (3)A6250 1 (3)A6256 3 (3)A6259 3 (3)
HCPCS MUEA6261 3 (3)A6262 3 (3)A6404 2 (3)A6407 4 (3)A6410 2 (3)A6411 2 (3)A6412 2 (3)A6413 0 (3)A6441 8 (3)A6442 8 (3)A6443 8 (3)A6444 4 (3)A6445 8 (3)A6446 14 (3)A6447 6 (3)A6448 24 (3)A6449 12 (3)A6450 8 (3)A6451 8 (3)A6452 22 (3)A6453 6 (3)A6454 25 (3)A6455 4 (3)A6456 20 (3)A6457 12 (3)A6501 1 (3)A6502 1 (3)A6503 1 (3)A6504 2 (3)A6505 2 (3)A6506 2 (3)A6507 2 (3)A6508 2 (3)A6509 1 (3)A6510 1 (3)A6511 1 (3)A6513 1 (3)A6530 0 (3)A6531 2 (3)A6532 2 (3)A6533 0 (3)A6534 0 (3)A6535 0 (3)A6536 0 (3)A6537 0 (3)A6538 0 (3)A6539 0 (3)A6540 0 (3)A6541 0 (3)A6544 0 (3)A6545 2 (3)A6549 0 (3)A6550 1 (3)A7000 0 (3)A7001 0 (3)A7002 0 (3)A7003 0 (3)A7004 0 (3)A7005 0 (3)A7006 0 (3)A7007 0 (3)A7008 0 (3)A7009 0 (3)A7010 0 (3)
HCPCS MUEA7012 0 (3)A7013 0 (3)A7014 0 (3)A7015 0 (3)A7016 0 (3)A7017 0 (3)A7018 0 (3)A7020 0 (3)A7025 0 (3)A7026 0 (3)A7027 0 (3)A7028 0 (3)A7029 0 (3)A7030 0 (3)A7031 0 (3)A7032 0 (3)A7033 0 (3)A7034 0 (3)A7035 0 (3)A7036 0 (3)A7037 0 (3)A7038 0 (3)A7039 0 (3)A7040 2 (3)A7041 2 (3)A7044 0 (3)A7045 0 (3)A7046 0 (3)A7047 1 (3)A7048 2 (3)A7501 1 (3)A7502 1 (3)A7503 1 (3)A7504 180 (3)A7505 1 (3)A7506 0 (3)A7507 200 (3)A7508 0 (3)A7509 0 (3)A7520 1 (3)A7521 1 (3)A7522 0 (3)A7523 0 (3)A7524 1 (3)A7525 0 (3)A7526 0 (3)A7527 1 (3)A8000 0 (3)A8001 0 (3)A8002 0 (3)A8003 0 (3)A8004 0 (3)A9152 0 (3)A9153 0 (3)A9155 1 (3)A9180 0 (3)A9270 0 (3)A9272 0 (3)A9273 0 (3)A9274 0 (3)A9275 0 (3)A9276 0 (3)A9277 0 (3)A9278 0 (3)
HCPCS MUE
Medically Unlikely Edits (MUEs) 2019 HCPCS Level II
10 © 2018 Optum360, LLC
Med
ical
ly U
nlik
ely
Edit
s (M
UEs
)—O
PPS
A9279 0 (3)A9280 0 (3)A9281 0 (3)A9282 0 (3)A9283 0 (3)A9284 0 (3)A9285 0 (3)A9286 0 (3)A9300 0 (3)A9500 3 (3)A9501 1 (3)A9502 3 (3)A9503 1 (3)A9504 1 (3)A9505 4 (3)A9507 1 (3)A9508 2 (3)A9509 5 (3)A9510 1 (3)A9512 30 (3)A9515 1 (3)A9516 4 (3)A9517 200 (3)A9520 1 (3)A9521 2 (3)A9524 10 (3)A9526 2 (3)A9527 195 (3)A9528 10 (3)A9529 10 (3)A9530 200 (3)A9531 100 (3)A9532 10 (3)A9536 1 (3)A9537 1 (3)A9538 1 (3)A9539 2 (3)A9540 2 (3)A9541 1 (3)A9542 1 (3)A9543 1 (3)A9546 1 (3)A9547 2 (3)A9548 2 (3)A9550 1 (3)A9551 1 (3)A9552 1 (3)A9553 1 (3)A9554 1 (3)A9555 2 (3)A9556 10 (3)A9557 2 (3)A9558 7 (3)A9559 1 (3)A9560 2 (3)A9561 1 (3)A9562 2 (3)A9563 10 (3)A9564 0 (3)A9566 1 (3)A9567 2 (3)A9568 0 (3)A9569 1 (3)A9570 1 (3)A9571 1 (3)
HCPCS MUEA9572 1 (3)A9575 300 (3)A9576 100 (3)A9577 50 (3)A9578 50 (3)A9579 100 (3)A9580 1 (3)A9581 20 (3)A9582 1 (3)A9583 18 (3)A9584 1 (3)A9585 300 (3)A9586 1 (3)A9587 54 (3)A9588 10 (3)A9600 7 (3)A9604 1 (3)A9606 224 (3)A9698 3 (3)A9700 2 (3)A9900 0 (3)A9901 0 (3)A9999 0 (3)B4034 0 (3)B4035 0 (3)B4036 0 (3)B4081 0 (3)B4082 0 (3)B4083 0 (3)B4087 1 (3)B4088 1 (3)B4100 0 (3)B4102 0 (3)B4103 0 (3)B4104 0 (3)B4149 0 (3)B4150 0 (3)B4152 0 (3)B4153 0 (3)B4154 0 (3)B4155 0 (3)B4157 0 (3)B4158 0 (3)B4159 0 (3)B4160 0 (3)B4161 0 (3)B4162 0 (3)B4164 0 (3)B4168 0 (3)B4172 0 (3)B4176 0 (3)B4178 0 (3)B4180 0 (3)B4185 0 (3)B4189 0 (3)B4193 0 (3)B4197 0 (3)B4199 0 (3)B4216 0 (3)B4220 0 (3)B4222 0 (3)B4224 0 (3)B5000 0 (3)B5100 0 (3)B5200 0 (3)
HCPCS MUEB9002 0 (3)B9004 0 (3)B9006 0 (3)B9998 0 (3)B9999 0 (3)C1713 20 (3)C1714 4 (3)C1715 45 (3)C1716 4 (3)C1717 10 (3)C1719 99 (3)C1721 1 (3)C1722 1 (3)C1724 5 (3)C1725 9 (3)C1726 5 (3)C1727 4 (3)C1728 5 (3)C1729 6 (3)C1730 4 (3)C1731 2 (3)C1732 3 (3)C1733 3 (3)C1749 1 (3)C1750 2 (3)C1751 3 (3)C1752 2 (3)C1753 2 (3)C1754 2 (3)C1755 2 (3)C1756 2 (3)C1757 6 (3)C1758 2 (3)C1759 2 (3)C1760 4 (3)C1762 4 (3)C1763 4 (3)C1764 1 (3)C1765 4 (3)C1766 4 (3)C1767 2 (3)C1768 3 (3)C1769 9 (3)C1770 3 (3)C1771 1 (3)C1772 1 (3)C1773 3 (3)C1776 10 (3)C1777 2 (3)C1778 4 (3)C1779 2 (3)C1780 2 (3)C1781 4 (3)C1782 1 (3)C1783 2 (3)C1784 2 (3)C1785 1 (3)C1786 1 (3)C1787 2 (3)C1788 2 (3)C1789 2 (3)C1813 1 (3)C1814 2 (3)C1815 1 (3)C1816 2 (3)
HCPCS MUEC1817 1 (3)C1818 2 (3)C1819 4 (3)C1820 2 (3)C1821 4 (3)C1822 1 (3)C1830 2 (3)C1840 1 (3)C1841 1 (2)C1842 0 (3)C1874 5 (3)C1875 4 (3)C1876 5 (3)C1877 5 (3)C1878 2 (3)C1880 2 (3)C1881 2 (3)C1882 1 (3)C1883 4 (3)C1884 4 (3)C1885 2 (3)C1886 1 (3)C1887 7 (3)C1888 2 (3)C1889 2 (3)C1891 1 (3)C1892 6 (3)C1893 6 (3)C1894 6 (3)C1895 2 (3)C1896 2 (3)C1897 2 (3)C1898 2 (3)C1899 2 (3)C1900 1 (3)C2613 2 (3)C2614 3 (3)C2615 2 (3)C2616 1 (3)C2617 4 (3)C2618 4 (3)C2619 1 (3)C2620 1 (3)C2621 1 (3)C2622 1 (3)C2623 4 (3)C2624 1 (3)C2625 4 (3)C2626 1 (3)C2627 2 (3)C2628 4 (3)C2629 4 (3)C2630 3 (3)C2631 1 (3)C2634 24 (3)C2635 124 (3)C2636 690 (3)C2637 0 (3)C2638 150 (3)C2639 150 (3)C2640 150 (3)C2641 150 (3)C2642 120 (3)C2643 120 (3)C2644 500 (1)
HCPCS MUEC2645 4608 (3)C5271 1 (2)C5272 3 (2)C5273 1 (2)C5274 35 (3)C5275 1 (2)C5276 3 (2)C5277 1 (2)C5278 15 (3)C8900 1 (3)C8901 1 (3)C8902 1 (3)C8903 1 (3)C8905 1 (3)C8906 1 (3)C8908 1 (3)C8909 1 (3)C8910 1 (3)C8911 1 (3)C8912 1 (3)C8913 1 (3)C8914 1 (3)C8918 1 (3)C8919 1 (3)C8920 1 (3)C8921 1 (3)C8922 1 (3)C8923 1 (3)C8924 1 (3)C8925 1 (3)C8926 1 (3)C8927 1 (3)C8928 1 (2)C8929 1 (3)C8930 1 (2)C8931 1 (3)C8932 1 (3)C8933 1 (3)C8934 2 (3)C8935 2 (3)C8936 2 (3)C8957 2 (3)C9113 10 (3)C9132 5500 (3)C9248 25 (3)C9250 5 (3)C9254 400 (3)C9257 8000 (3)C9285 2 (3)C9290 266 (3)C9293 700 (3)C9352 3 (3)C9353 4 (3)C9354 300 (3)C9355 3 (3)C9356 125 (3)C9358 800 (3)C9359 30 (3)C9360 300 (3)C9361 10 (3)C9362 60 (3)C9363 500 (3)C9364 600 (3)C9447 1 (3)C9460 100 (3)
HCPCS MUEC9462 600 (3)C9482 300 (3)C9488 40 (3)C9600 3 (3)C9601 2 (3)C9602 2 (3)C9603 2 (3)C9604 2 (3)C9605 2 (3)C9606 1 (3)C9607 1 (2)C9608 2 (3)C9725 1 (3)C9726 2 (3)C9727 1 (2)C9728 1 (2)C9733 1 (3)C9734 1 (3)C9738 1 (3)C9739 1 (2)C9740 1 (2)C9745 1 (2)C9746 1 (2)C9747 1 (2)C9749 1 (2)C9898 1 (3)E0100 0 (3)E0105 0 (3)E0110 0 (3)E0111 0 (3)E0112 0 (3)E0113 0 (3)E0114 0 (3)E0116 0 (3)E0117 0 (3)E0118 0 (3)E0130 0 (3)E0135 0 (3)E0140 0 (3)E0141 0 (3)E0143 0 (3)E0144 0 (3)E0147 0 (3)E0148 0 (3)E0149 0 (3)E0153 0 (3)E0154 0 (3)E0155 0 (3)E0156 0 (3)E0157 0 (3)E0158 0 (3)E0159 0 (3)E0160 0 (3)E0161 0 (3)E0162 0 (3)E0163 0 (3)E0165 0 (3)E0167 0 (3)E0168 0 (3)E0170 0 (3)E0171 0 (3)E0172 0 (3)E0175 0 (3)E0181 0 (3)E0182 0 (3)
HCPCS MUEE0184 0 (3)E0185 0 (3)E0186 0 (3)E0187 0 (3)E0188 0 (3)E0189 0 (3)E0190 0 (3)E0191 0 (3)E0193 0 (3)E0194 0 (3)E0196 0 (3)E0197 0 (3)E0198 0 (3)E0199 0 (3)E0200 0 (3)E0202 0 (3)E0203 0 (3)E0205 0 (3)E0210 0 (3)E0215 0 (3)E0217 0 (3)E0218 0 (3)E0221 0 (3)E0225 0 (3)E0231 0 (3)E0232 0 (3)E0235 0 (3)E0236 0 (3)E0239 0 (3)E0240 0 (3)E0241 0 (3)E0242 0 (3)E0243 0 (3)E0244 0 (3)E0245 0 (3)E0246 0 (3)E0247 0 (3)E0248 0 (3)E0249 0 (3)E0250 0 (3)E0251 0 (3)E0255 0 (3)E0256 0 (3)E0260 0 (3)E0261 0 (3)E0265 0 (3)E0266 0 (3)E0270 0 (3)E0271 0 (3)E0272 0 (3)E0273 0 (3)E0274 0 (3)E0275 0 (3)E0276 0 (3)E0277 0 (3)E0280 0 (3)E0290 0 (3)E0291 0 (3)E0292 0 (3)E0293 0 (3)E0294 0 (3)E0295 0 (3)E0296 0 (3)E0297 0 (3)E0300 0 (3)
HCPCS MUEE0301 0 (3)E0302 0 (3)E0303 0 (3)E0304 0 (3)E0305 0 (3)E0310 0 (3)E0315 0 (3)E0316 0 (3)E0325 0 (3)E0326 0 (3)E0328 0 (3)E0329 0 (3)E0350 0 (3)E0352 0 (3)E0370 0 (3)E0371 0 (3)E0372 0 (3)E0373 0 (3)E0424 0 (3)E0425 0 (3)E0430 0 (3)E0431 0 (3)E0433 0 (3)E0434 0 (3)E0435 0 (3)E0439 0 (3)E0440 0 (3)E0441 0 (3)E0442 0 (3)E0443 0 (3)E0444 0 (3)E0445 0 (3)E0446 0 (3)E0455 0 (3)E0457 0 (3)E0459 0 (3)E0462 0 (3)E0465 0 (3)E0466 0 (3)E0470 0 (3)E0471 0 (3)E0472 0 (3)E0480 0 (3)E0481 0 (3)E0482 0 (3)E0483 0 (3)E0484 0 (3)E0485 0 (3)E0486 0 (3)E0487 0 (3)E0500 0 (3)E0550 0 (3)E0555 0 (3)E0560 0 (3)E0561 0 (3)E0562 0 (3)E0565 0 (3)E0570 0 (3)E0572 0 (3)E0574 0 (3)E0575 0 (3)E0580 0 (3)E0585 0 (3)E0600 0 (3)E0601 0 (3)
HCPCS MUE
2019 HCPCS Level II Medically Unlikely Edits (MUEs)
© 2018 Optum360, LLC 11
Medically U
nlikely Edits (MU
Es)—O
PPS
E0602 0 (3)E0603 0 (3)E0604 0 (3)E0605 0 (3)E0606 0 (3)E0607 0 (3)E0610 0 (3)E0615 0 (3)E0616 1 (2)E0617 0 (3)E0618 0 (3)E0619 0 (3)E0620 0 (3)E0621 0 (3)E0625 0 (3)E0627 0 (3)E0629 0 (3)E0630 0 (3)E0635 0 (3)E0636 0 (3)E0637 0 (3)E0638 0 (3)E0639 0 (3)E0640 0 (3)E0641 0 (3)E0642 0 (3)E0650 0 (3)E0651 0 (3)E0652 0 (3)E0655 0 (3)E0656 0 (3)E0657 0 (3)E0660 0 (3)E0665 0 (3)E0666 0 (3)E0667 0 (3)E0668 0 (3)E0669 0 (3)E0670 0 (3)E0671 0 (3)E0672 0 (3)E0673 0 (3)E0675 0 (3)E0676 1 (3)E0691 0 (3)E0692 0 (3)E0693 0 (3)E0694 0 (3)E0700 0 (3)E0705 1 (2)E0710 0 (3)E0720 0 (3)E0730 0 (3)E0731 0 (3)E0740 0 (3)E0744 0 (3)E0745 0 (3)E0746 1 (3)E0747 0 (3)E0748 0 (3)E0749 1 (3)E0755 0 (3)E0760 0 (3)E0761 0 (3)E0762 1 (3)
HCPCS MUEE0764 0 (3)E0765 0 (3)E0766 0 (3)E0769 0 (3)E0770 1 (3)E0776 0 (3)E0779 0 (3)E0780 0 (3)E0781 0 (3)E0782 1 (2)E0783 1 (2)E0784 0 (3)E0785 1 (2)E0786 1 (2)E0791 0 (3)E0830 0 (3)E0840 0 (3)E0849 0 (3)E0850 0 (3)E0855 0 (3)E0856 0 (3)E0860 0 (3)E0870 0 (3)E0880 0 (3)E0890 0 (3)E0900 0 (3)E0910 0 (3)E0911 0 (3)E0912 0 (3)E0920 0 (3)E0930 0 (3)E0935 0 (3)E0936 0 (3)E0940 0 (3)E0941 0 (3)E0942 0 (3)E0944 0 (3)E0945 0 (3)E0946 0 (3)E0947 0 (3)E0948 0 (3)E0950 0 (3)E0951 0 (3)E0952 0 (3)E0953 0 (3)E0954 0 (3)E0955 0 (3)E0956 0 (3)E0957 0 (3)E0958 0 (3)E0959 2 (2)E0960 0 (3)E0961 2 (2)E0966 1 (2)E0967 0 (3)E0968 0 (3)E0969 0 (3)E0970 0 (3)E0971 2 (3)E0973 2 (2)E0974 2 (2)E0978 1 (3)E0980 0 (3)E0981 0 (3)E0982 0 (3)
HCPCS MUEE0983 0 (3)E0984 0 (3)E0985 0 (3)E0986 0 (3)E0988 0 (3)E0990 2 (2)E0992 1 (2)E0994 0 (3)E0995 2 (2)E1002 0 (3)E1003 0 (3)E1004 0 (3)E1005 0 (3)E1006 0 (3)E1007 0 (3)E1008 0 (3)E1009 0 (3)E1010 0 (3)E1011 0 (3)E1012 0 (3)E1014 0 (3)E1015 0 (3)E1016 0 (3)E1017 0 (3)E1018 0 (3)E1020 0 (3)E1028 0 (3)E1029 0 (3)E1030 0 (3)E1031 0 (3)E1035 0 (3)E1036 0 (3)E1037 0 (3)E1038 0 (3)E1039 0 (3)E1050 0 (3)E1060 0 (3)E1070 0 (3)E1083 0 (3)E1084 0 (3)E1085 0 (3)E1086 0 (3)E1087 0 (3)E1088 0 (3)E1089 0 (3)E1090 0 (3)E1092 0 (3)E1093 0 (3)E1100 0 (3)E1110 0 (3)E1130 0 (3)E1140 0 (3)E1150 0 (3)E1160 0 (3)E1161 0 (3)E1170 0 (3)E1171 0 (3)E1172 0 (3)E1180 0 (3)E1190 0 (3)E1195 0 (3)E1200 0 (3)E1220 0 (3)E1221 0 (3)E1222 0 (3)
HCPCS MUEE1223 0 (3)E1224 0 (3)E1225 0 (3)E1226 1 (2)E1227 0 (3)E1228 0 (3)E1229 0 (3)E1230 0 (3)E1231 0 (3)E1232 0 (3)E1233 0 (3)E1234 0 (3)E1235 0 (3)E1236 0 (3)E1237 0 (3)E1238 0 (3)E1239 0 (3)E1240 0 (3)E1250 0 (3)E1260 0 (3)E1270 0 (3)E1280 0 (3)E1285 0 (3)E1290 0 (3)E1295 0 (3)E1296 0 (3)E1297 0 (3)E1298 0 (3)E1300 0 (3)E1310 0 (3)E1352 0 (3)E1353 0 (3)E1354 0 (3)E1355 0 (3)E1356 0 (3)E1357 0 (3)E1358 0 (3)E1372 0 (3)E1390 0 (3)E1391 0 (3)E1392 0 (3)E1399 0 (3)E1405 0 (3)E1406 0 (3)E1500 0 (3)E1510 0 (3)E1520 0 (3)E1530 0 (3)E1540 0 (3)E1550 0 (3)E1560 0 (3)E1570 0 (3)E1575 0 (3)E1580 0 (3)E1590 0 (3)E1592 0 (3)E1594 0 (3)E1600 0 (3)E1610 0 (3)E1615 0 (3)E1620 0 (3)E1625 0 (3)E1630 0 (3)E1632 0 (3)E1634 0 (3)
HCPCS MUEE1635 0 (3)E1636 0 (3)E1637 0 (3)E1639 0 (3)E1699 1 (3)E1700 0 (3)E1701 0 (3)E1702 0 (3)E1800 0 (3)E1801 0 (3)E1802 0 (3)E1805 0 (3)E1806 0 (3)E1810 0 (3)E1811 0 (3)E1812 0 (3)E1815 0 (3)E1816 0 (3)E1818 0 (3)E1820 0 (3)E1821 0 (3)E1825 0 (3)E1830 0 (3)E1831 0 (3)E1840 0 (3)E1841 0 (3)E1902 0 (3)E2000 0 (3)E2100 0 (3)E2101 0 (3)E2120 0 (3)E2201 0 (3)E2202 0 (3)E2203 0 (3)E2204 0 (3)E2205 0 (3)E2206 0 (3)E2207 0 (3)E2208 0 (3)E2209 0 (3)E2210 0 (3)E2211 0 (3)E2212 0 (3)E2213 0 (3)E2214 0 (3)E2215 0 (3)E2216 0 (3)E2217 0 (3)E2218 0 (3)E2219 0 (3)E2220 0 (3)E2221 0 (3)E2222 0 (3)E2224 0 (3)E2225 0 (3)E2226 0 (3)E2227 0 (3)E2228 0 (3)E2230 0 (3)E2231 0 (3)E2291 1 (2)E2292 1 (2)E2293 1 (2)E2294 1 (2)E2295 0 (3)
HCPCS MUEE2300 0 (3)E2301 0 (3)E2310 0 (3)E2311 0 (3)E2312 0 (3)E2313 0 (3)E2321 0 (3)E2322 0 (3)E2323 0 (3)E2324 0 (3)E2325 0 (3)E2326 0 (3)E2327 0 (3)E2328 0 (3)E2329 0 (3)E2330 0 (3)E2331 0 (3)E2340 0 (3)E2341 0 (3)E2342 0 (3)E2343 0 (3)E2351 0 (3)E2358 0 (3)E2359 0 (3)E2360 0 (3)E2361 0 (3)E2362 0 (3)E2363 0 (3)E2364 0 (3)E2365 0 (3)E2366 0 (3)E2367 0 (3)E2368 0 (3)E2369 0 (3)E2370 0 (3)E2371 0 (3)E2372 0 (3)E2373 0 (3)E2374 0 (3)E2375 0 (3)E2376 0 (3)E2377 0 (3)E2378 0 (3)E2381 0 (3)E2382 0 (3)E2383 0 (3)E2384 0 (3)E2385 0 (3)E2386 0 (3)E2387 0 (3)E2388 0 (3)E2389 0 (3)E2390 0 (3)E2391 0 (3)E2392 0 (3)E2394 0 (3)E2395 0 (3)E2396 0 (3)E2397 0 (3)E2402 0 (3)E2500 0 (3)E2502 0 (3)E2504 0 (3)E2506 0 (3)E2508 0 (3)
HCPCS MUEE2510 0 (3)E2511 0 (3)E2512 0 (3)E2599 0 (3)E2601 0 (3)E2602 0 (3)E2603 0 (3)E2604 0 (3)E2605 0 (3)E2606 0 (3)E2607 0 (3)E2608 0 (3)E2609 0 (3)E2610 1 (3)E2611 0 (3)E2612 0 (3)E2613 0 (3)E2614 0 (3)E2615 0 (3)E2616 0 (3)E2617 0 (3)E2619 0 (3)E2620 0 (3)E2621 0 (3)E2622 0 (3)E2623 0 (3)E2624 0 (3)E2625 0 (3)E2626 0 (3)E2627 0 (3)E2628 0 (3)E2629 0 (3)E2630 0 (3)E2631 0 (3)E2632 0 (3)E2633 0 (3)E8000 0 (3)E8001 0 (3)E8002 0 (3)G0008 1 (2)G0009 1 (2)G0010 1 (3)G0027 1 (2)G0101 1 (2)G0102 1 (2)G0103 1 (2)G0104 1 (2)G0105 1 (2)G0106 1 (2)G0108 8 (3)G0109 12 (3)G0117 1 (2)G0118 1 (2)G0120 1 (2)G0121 1 (2)G0122 0 (3)G0123 1 (3)G0124 1 (3)G0127 1 (2)G0128 1 (3)G0129 6 (3)G0130 1 (2)G0141 1 (3)G0143 1 (3)G0144 1 (3)
HCPCS MUEG0145 1 (3)G0147 1 (3)G0148 1 (3)G0166 2 (3)G0168 2 (3)G0175 1 (3)G0176 5 (3)G0177 5 (3)G0179 1 (2)G0180 1 (2)G0181 1 (2)G0182 1 (2)G0186 1 (2)G0219 0 (3)G0235 1 (3)G0237 8 (3)G0238 8 (3)G0239 2 (3)G0245 1 (2)G0246 1 (2)G0247 1 (2)G0248 1 (2)G0249 3 (3)G0250 1 (2)G0252 0 (3)G0255 0 (3)G0257 1 (3)G0259 2 (3)G0260 2 (3)G0268 1 (2)G0269 2 (3)G0270 8 (3)G0271 4 (3)G0276 1 (3)G0277 5 (3)G0278 1 (2)G0279 1 (2)G0281 1 (3)G0282 0 (3)G0283 1 (3)G0288 1 (2)G0289 1 (2)G0293 1 (2)G0294 1 (2)G0295 0 (3)G0296 1 (2)G0297 1 (2)G0302 1 (2)G0303 1 (2)G0304 1 (2)G0305 1 (2)G0306 4 (3)G0307 4 (3)G0328 1 (2)G0329 1 (3)G0333 0 (3)G0337 1 (2)G0339 1 (2)G0340 1 (3)G0341 1 (2)G0342 1 (2)G0343 1 (2)G0365 2 (3)G0372 1 (2)G0378 72 (3)
HCPCS MUE
Medically Unlikely Edits (MUEs) 2019 HCPCS Level II
12 © 2018 Optum360, LLC
Med
ical
ly U
nlik
ely
Edit
s (M
UEs
)—O
PPS
G0379 1 (2)G0380 2 (3)G0381 2 (3)G0382 2 (3)G0383 2 (3)G0384 2 (3)G0390 1 (2)G0396 1 (2)G0397 1 (2)G0398 1 (2)G0399 1 (2)G0400 1 (2)G0402 1 (2)G0403 1 (2)G0404 1 (2)G0405 1 (2)G0406 1 (3)G0407 1 (3)G0408 1 (3)G0410 6 (3)G0411 6 (3)G0412 1 (2)G0413 1 (2)G0414 1 (2)G0415 1 (2)G0416 1 (2)G0420 2 (3)G0421 4 (3)G0422 6 (2)G0423 6 (2)G0424 2 (2)G0425 1 (3)G0426 1 (3)G0427 1 (3)G0428 0 (3)G0429 1 (2)G0432 1 (2)G0433 1 (2)G0435 1 (2)G0438 1 (2)G0439 1 (2)G0442 1 (2)G0443 1 (2)G0444 1 (2)G0445 1 (2)G0446 1 (3)G0447 2 (3)G0448 1 (3)G0451 1 (3)G0452 1 (3)G0453 10 (3)G0454 1 (2)G0455 1 (2)G0458 1 (3)G0459 1 (3)G0460 1 (3)G0463 4 (3)G0466 1 (2)G0467 1 (3)G0468 1 (2)G0469 1 (2)G0470 1 (3)G0471 2 (3)G0472 1 (2)G0473 1 (3)
HCPCS MUEG0475 1 (2)G0476 1 (2)G0480 1 (2)G0481 1 (2)G0482 1 (2)G0483 1 (2)G0490 1 (3)G0491 1 (3)G0492 1 (3)G0493 1 (3)G0494 1 (3)G0495 1 (3)G0496 1 (3)G0498 1 (2)G0499 1 (2)G0500 1 (3)G0501 1 (3)G0506 1 (2)G0508 1 (2)G0509 1 (2)G0511 1 (2)G0512 1 (2)G0513 1 (2)G0514 1 (1)G0515 8 (3)G0516 1 (2)G0517 1 (2)G0518 1 (2)G0659 1 (2)G6001 2 (3)G6002 2 (3)G6003 2 (3)G6004 2 (3)G6005 2 (3)G6006 2 (3)G6007 2 (3)G6008 2 (3)G6009 2 (3)G6010 2 (3)G6011 2 (3)G6012 2 (3)G6013 2 (3)G6014 2 (3)G6015 2 (3)G6016 2 (3)G6017 2 (3)G9143 1 (2)G9147 0 (3)G9148 0 (3)G9149 0 (3)G9150 0 (3)G9151 0 (3)G9152 0 (3)G9153 0 (3)G9156 1 (2)G9157 1 (2)G9187 0 (3)G9480 1 (3)G9481 2 (3)G9482 2 (3)G9483 2 (3)G9484 2 (3)G9485 2 (3)G9486 2 (3)G9487 2 (3)
HCPCS MUEG9488 2 (3)G9489 2 (3)G9490 2 (3)G9678 1 (2)G9685 0 (3)J0120 1 (3)J0129 100 (3)J0130 6 (3)J0131 400 (3)J0132 300 (3)J0133 1200 (3)J0135 8 (3)J0153 180 (3)J0171 120 (3)J0178 4 (3)J0180 140 (3)J0190 0 (3)J0200 0 (3)J0202 12 (3)J0205 0 (3)J0207 4 (3)J0210 16 (3)J0215 0 (3)J0220 20 (3)J0221 300 (3)J0256 1600 (3)J0257 1400 (3)J0270 32 (3)J0275 1 (3)J0278 15 (3)J0280 10 (3)J0282 70 (3)J0285 6 (3)J0287 60 (3)J0288 0 (3)J0289 115 (3)J0290 24 (3)J0295 12 (3)J0300 8 (3)J0330 50 (3)J0348 200 (3)J0350 0 (3)J0360 6 (3)J0364 6 (3)J0365 0 (3)J0380 1 (3)J0390 0 (3)J0395 0 (3)J0400 120 (3)J0401 400 (3)J0456 4 (3)J0461 800 (3)J0470 2 (3)J0475 8 (3)J0476 2 (3)J0480 1 (3)J0485 1500 (3)J0490 160 (3)J0500 4 (3)J0515 6 (3)J0520 0 (3)J0558 24 (3)J0561 24 (3)J0565 200 (3)J0570 4 (3)
HCPCS MUEJ0571 0 (3)J0572 0 (3)J0573 0 (3)J0574 0 (3)J0575 0 (3)J0583 1250 (3)J0585 600 (3)J0586 300 (3)J0587 300 (3)J0588 600 (3)J0592 12 (3)J0594 320 (3)J0595 12 (3)J0596 840 (3)J0597 250 (3)J0598 100 (3)J0600 3 (3)J0604 180 (3)J0606 150 (3)J0610 15 (3)J0620 1 (3)J0630 8 (3)J0636 100 (3)J0637 20 (3)J0638 150 (3)J0640 24 (3)J0641 1200 (3)J0670 10 (3)J0690 16 (3)J0692 12 (3)J0694 12 (3)J0695 60 (3)J0696 16 (3)J0697 12 (3)J0698 12 (3)J0702 20 (3)J0706 16 (3)J0710 0 (3)J0712 180 (3)J0713 12 (3)J0714 12 (3)J0715 0 (3)J0716 4 (1)J0717 400 (3)J0720 15 (3)J0725 10 (3)J0735 50 (3)J0740 2 (3)J0743 16 (3)J0744 8 (3)J0745 8 (3)J0770 5 (3)J0775 180 (3)J0780 10 (3)J0795 100 (3)J0800 3 (3)J0834 3 (3)J0840 18 (3)J0850 9 (3)J0875 300 (3)J0878 1500 (3)J0881 500 (3)J0882 300 (3)J0883 1250 (3)J0884 1250 (3)
HCPCS MUEJ0885 60 (3)J0887 360 (3)J0888 360 (3)J0890 0 (3)J0894 100 (3)J0895 12 (3)J0897 120 (3)J0945 4 (3)J1000 1 (3)J1020 8 (3)J1030 8 (3)J1040 4 (3)J1050 1000 (3)J1071 400 (3)J1094 0 (3)J1100 120 (3)J1110 3 (3)J1120 2 (3)J1130 300 (3)J1160 3 (3)J1162 10 (3)J1165 50 (3)J1170 50 (3)J1180 0 (3)J1190 8 (3)J1200 8 (3)J1205 4 (3)J1212 1 (3)J1230 5 (3)J1240 6 (3)J1245 6 (3)J1250 4 (3)J1260 2 (3)J1265 100 (3)J1267 150 (3)J1270 16 (3)J1290 60 (3)J1300 120 (3)J1320 0 (3)J1322 150 (3)J1324 0 (3)J1325 18 (3)J1327 99 (3)J1330 1 (3)J1335 2 (3)J1364 8 (3)J1380 4 (3)J1410 4 (3)J1428 450 (3)J1430 10 (3)J1435 0 (3)J1436 0 (3)J1438 2 (3)J1439 750 (3)J1442 1500 (3)J1443 272 (3)J1447 960 (3)J1450 4 (3)J1451 200 (3)J1452 0 (3)J1453 150 (3)J1455 18 (3)J1457 0 (3)J1458 100 (3)J1459 300 (3)
HCPCS MUEJ1460 10 (2)J1555 480 (3)J1556 300 (3)J1557 300 (3)J1559 300 (3)J1560 1 (2)J1561 300 (3)J1562 0 (3)J1566 300 (3)J1568 300 (3)J1569 300 (3)J1570 4 (3)J1571 20 (3)J1572 300 (3)J1573 130 (3)J1575 650 (3)J1580 9 (3)J1595 2 (3)J1599 300 (3)J1600 0 (3)J1602 300 (3)J1610 3 (3)J1620 0 (3)J1626 30 (3)J1627 100 (3)J1630 7 (3)J1631 9 (3)J1640 672 (3)J1642 150 (3)J1644 50 (3)J1645 10 (3)J1650 30 (3)J1652 20 (3)J1655 0 (3)J1670 2 (3)J1675 0 (3)J1700 0 (3)J1710 0 (3)J1720 10 (3)J1726 28 (3)J1729 700 (3)J1730 0 (3)J1740 3 (3)J1741 32 (3)J1742 4 (3)J1743 66 (3)J1744 90 (3)J1745 150 (3)J1750 45 (3)J1756 500 (3)J1786 680 (3)J1790 2 (3)J1800 12 (3)J1810 0 (3)J1815 200 (3)J1817 0 (3)J1826 1 (3)J1830 1 (3)J1833 1116 (3)J1835 0 (3)J1840 3 (3)J1850 14 (3)J1885 8 (3)J1890 0 (3)J1930 120 (3)
HCPCS MUEJ1931 609 (3)J1940 10 (3)J1942 1064 (3)J1945 0 (3)J1950 12 (3)J1953 300 (3)J1955 11 (3)J1956 4 (3)J1960 0 (3)J1980 8 (3)J1990 0 (3)J2001 400 (3)J2010 10 (3)J2020 6 (3)J2060 10 (3)J2150 8 (3)J2170 8 (3)J2175 6 (3)J2180 0 (3)J2182 300 (3)J2185 60 (3)J2210 5 (3)J2212 240 (3)J2248 300 (3)J2250 30 (3)J2260 16 (3)J2265 400 (3)J2270 15 (3)J2274 100 (3)J2278 1000 (3)J2280 8 (3)J2300 10 (3)J2310 10 (3)J2315 380 (3)J2320 4 (3)J2323 300 (3)J2325 34 (3)J2326 120 (3)J2350 600 (3)J2353 60 (3)J2354 60 (3)J2355 2 (3)J2357 90 (3)J2358 405 (3)J2360 3 (3)J2370 30 (3)J2400 4 (3)J2405 64 (3)J2407 120 (3)J2410 2 (3)J2425 125 (3)J2426 819 (3)J2430 3 (3)J2440 4 (3)J2460 0 (3)J2469 10 (3)J2501 25 (3)J2502 60 (3)J2503 2 (3)J2504 15 (3)J2505 1 (3)J2507 8 (3)J2510 4 (3)J2513 1 (3)J2515 8 (3)
HCPCS MUEJ2540 75 (3)J2543 20 (3)J2545 1 (3)J2547 600 (3)J2550 3 (3)J2560 16 (3)J2562 48 (3)J2590 15 (3)J2597 45 (3)J2650 0 (3)J2670 0 (3)J2675 1 (3)J2680 4 (3)J2690 4 (3)J2700 48 (3)J2704 400 (3)J2710 10 (3)J2720 10 (3)J2724 3500 (3)J2725 0 (3)J2730 2 (3)J2760 2 (3)J2765 18 (3)J2770 7 (3)J2778 10 (3)J2780 16 (3)J2783 60 (3)J2785 4 (3)J2786 500 (3)J2788 1 (3)J2790 3 (3)J2791 275 (3)J2792 450 (3)J2793 320 (3)J2794 100 (3)J2795 2400 (3)J2796 150 (3)J2800 3 (3)J2805 3 (3)J2810 20 (3)J2820 10 (3)J2840 160 (3)J2850 48 (3)J2860 170 (3)J2910 0 (3)J2916 20 (3)J2920 25 (3)J2930 25 (3)J2940 0 (3)J2941 8 (3)J2950 0 (3)J2993 2 (3)J2995 0 (3)J2997 100 (3)J3000 2 (3)J3010 100 (3)J3030 2 (3)J3060 760 (3)J3070 3 (3)J3090 200 (3)J3095 150 (3)J3101 50 (3)J3105 4 (3)J3110 2 (3)J3121 400 (3)
HCPCS MUE
2019 HCPCS Level II Medically Unlikely Edits (MUEs)
© 2018 Optum360, LLC 13
Medically U
nlikely Edits (MU
Es)—O
PPS
J3145 750 (3)J3230 6 (3)J3240 1 (3)J3243 200 (3)J3246 100 (3)J3250 4 (3)J3260 12 (3)J3262 800 (3)J3265 0 (3)J3280 0 (3)J3285 9 (3)J3300 160 (3)J3301 16 (3)J3302 0 (3)J3303 24 (3)J3305 0 (3)J3310 0 (3)J3315 6 (3)J3320 0 (3)J3350 0 (3)J3355 0 (3)J3357 90 (3)J3358 520 (3)J3360 6 (3)J3364 0 (3)J3365 0 (3)J3370 12 (3)J3380 300 (3)J3385 80 (3)J3396 150 (3)J3400 0 (3)J3410 16 (3)J3411 8 (3)J3415 6 (3)J3420 1 (3)J3430 50 (3)J3465 120 (3)J3470 3 (3)J3471 999 (2)J3472 2 (3)J3473 450 (3)J3475 80 (3)J3480 200 (3)J3485 160 (3)J3486 4 (3)J3489 5 (3)J3520 0 (3)J3530 0 (3)J3535 0 (3)J3570 0 (3)J7030 20 (3)J7040 12 (3)J7042 12 (3)J7050 20 (3)J7060 10 (3)J7070 7 (3)J7100 2 (3)J7110 3 (3)J7120 20 (3)J7121 5 (3)J7131 500 (3)J7175 9000 (1)J7178 7700 (1)J7179 9600 (1)J7180 6000 (1)
HCPCS MUEJ7181 3850 (1)J7182 22000 (1)J7183 9600 (1)J7185 22000 (1)J7186 9600 (1)J7187 9600 (1)J7188 22000 (1)J7189 26000 (1)J7190 22000 (1)J7191 0 (3)J7192 22000 (1)J7193 20000 (1)J7194 9000 (1)J7195 20000 (1)J7196 0 (3)J7197 6300 (1)J7198 30000 (1)J7200 20000 (1)J7201 9000 (1)J7202 11550 (1)J7205 9750 (1)J7207 7500 (1)J7209 7500 (1)J7210 22000 (1)J7211 22000 (1)J7296 0 (3)J7297 0 (3)J7298 0 (3)J7300 0 (3)J7301 0 (3)J7303 0 (3)J7304 0 (3)J7306 0 (3)J7307 0 (3)J7308 3 (3)J7309 1 (3)J7310 0 (3)J7311 1 (3)J7312 14 (3)J7313 38 (3)J7315 2 (3)J7316 3 (2)J7320 50 (3)J7321 2 (2)J7322 48 (3)J7323 2 (2)J7324 2 (2)J7325 96 (3)J7326 2 (2)J7327 2 (2)J7328 336 (3)J7330 1 (3)J7336 1120 (3)J7340 1 (3)J7342 10 (3)J7345 200 (3)J7500 15 (3)J7501 8 (3)J7502 60 (3)J7503 120 (3)J7504 15 (3)J7505 1 (3)J7507 40 (3)J7508 300 (3)J7509 60 (3)
HCPCS MUEJ7510 60 (3)J7511 9 (3)J7512 300 (3)J7513 0 (3)J7515 90 (3)J7516 4 (3)J7517 16 (3)J7518 12 (3)J7520 40 (3)J7525 2 (3)J7527 20 (3)J7599 1 (3)J7604 0 (3)J7605 0 (3)J7606 0 (3)J7607 0 (3)J7608 0 (3)J7609 0 (3)J7610 0 (3)J7611 0 (3)J7612 0 (3)J7613 0 (3)J7614 0 (3)J7615 0 (3)J7620 0 (3)J7622 0 (3)J7624 0 (3)J7626 0 (3)J7627 0 (3)J7628 0 (3)J7629 0 (3)J7631 0 (3)J7632 0 (3)J7633 0 (3)J7634 0 (3)J7635 0 (3)J7636 0 (3)J7637 0 (3)J7638 0 (3)J7639 0 (3)J7640 0 (3)J7641 0 (3)J7642 0 (3)J7643 0 (3)J7644 0 (3)J7645 0 (3)J7647 0 (3)J7648 0 (3)J7649 0 (3)J7650 0 (3)J7657 0 (3)J7658 0 (3)J7659 0 (3)J7660 0 (3)J7665 0 (3)J7667 0 (3)J7668 0 (3)J7669 0 (3)J7670 0 (3)J7674 100 (3)J7676 0 (3)J7680 0 (3)J7681 0 (3)J7682 0 (3)J7683 0 (3)
HCPCS MUEJ7684 0 (3)J7685 0 (3)J7686 0 (3)J7699 0 (3)J7799 2 (3)J7999 6 (3)J8498 1 (3)J8499 0 (3)J8501 57 (3)J8510 5 (3)J8515 0 (3)J8520 50 (3)J8521 15 (3)J8530 60 (3)J8540 48 (3)J8560 6 (3)J8562 12 (3)J8565 0 (3)J8597 4 (3)J8600 40 (3)J8610 20 (3)J8650 0 (3)J8655 1 (3)J8670 180 (3)J8700 120 (3)J8705 22 (3)J8999 2 (3)J9000 20 (3)J9015 1 (3)J9017 30 (3)J9019 60 (3)J9020 0 (3)J9022 120 (3)J9023 160 (3)J9025 300 (3)J9027 100 (3)J9031 1 (3)J9032 300 (3)J9033 300 (3)J9034 360 (3)J9035 170 (3)J9039 210 (3)J9040 4 (3)J9041 35 (3)J9042 200 (3)J9043 60 (3)J9045 22 (3)J9047 160 (3)J9050 6 (3)J9055 120 (3)J9060 24 (3)J9065 100 (3)J9070 55 (3)J9098 5 (3)J9100 120 (3)J9120 5 (3)J9130 24 (3)J9145 240 (3)J9150 12 (3)J9151 0 (3)J9155 240 (3)J9160 0 (3)J9165 0 (3)J9171 240 (3)J9175 10 (3)
HCPCS MUEJ9176 3000 (3)J9178 150 (3)J9179 50 (3)J9181 100 (3)J9185 2 (3)J9190 20 (3)J9200 20 (3)J9201 20 (3)J9202 3 (3)J9203 180 (3)J9205 215 (3)J9206 42 (3)J9207 90 (3)J9208 15 (3)J9209 55 (3)J9211 6 (3)J9212 0 (3)J9213 12 (3)J9214 100 (3)J9215 0 (3)J9216 0 (3)J9217 6 (3)J9218 1 (3)J9219 0 (3)J9225 1 (3)J9226 1 (3)J9228 1100 (3)J9230 5 (3)J9245 11 (3)J9250 50 (3)J9260 20 (3)J9261 80 (3)J9262 700 (3)J9263 700 (3)J9264 600 (3)J9266 2 (3)J9267 750 (3)J9268 1 (3)J9270 0 (3)J9271 300 (3)J9280 12 (3)J9285 250 (3)J9293 8 (3)J9295 800 (3)J9299 480 (3)J9301 100 (3)J9302 200 (3)J9303 90 (3)J9305 150 (3)J9306 840 (3)J9307 80 (3)J9308 280 (3)J9315 40 (3)J9320 4 (3)J9325 400 (3)J9328 400 (3)J9330 50 (3)J9340 4 (3)J9351 120 (3)J9352 40 (3)J9354 600 (3)J9355 100 (3)J9357 4 (3)J9360 45 (3)J9370 4 (3)
HCPCS MUEJ9371 5 (3)J9390 36 (3)J9395 20 (3)J9400 500 (3)J9600 4 (3)K0001 0 (3)K0002 0 (3)K0003 0 (3)K0004 0 (3)K0005 0 (3)K0006 0 (3)K0007 0 (3)K0008 0 (3)K0009 0 (3)K0010 0 (3)K0011 0 (3)K0012 0 (3)K0013 0 (3)K0014 0 (3)K0015 0 (3)K0017 0 (3)K0018 0 (3)K0019 0 (3)K0020 0 (3)K0037 0 (3)K0038 0 (3)K0039 0 (3)K0040 0 (3)K0041 0 (3)K0042 0 (3)K0043 0 (3)K0044 0 (3)K0045 0 (3)K0046 0 (3)K0047 0 (3)K0050 0 (3)K0051 0 (3)K0052 0 (3)K0053 0 (3)K0056 0 (3)K0065 0 (3)K0069 0 (3)K0070 0 (3)K0071 0 (3)K0072 0 (3)K0073 0 (3)K0077 0 (3)K0098 0 (3)K0105 0 (3)K0108 0 (3)K0195 0 (3)K0455 0 (3)K0462 0 (3)K0552 0 (3)K0553 0 (3)K0554 0 (3)K0601 0 (3)K0602 0 (3)K0603 0 (3)K0604 0 (3)K0605 0 (3)K0606 0 (3)K0607 0 (3)K0608 0 (3)K0609 0 (3)
HCPCS MUEK0669 0 (3)K0672 4 (3)K0730 0 (3)K0733 0 (3)K0738 0 (3)K0740 0 (3)K0743 0 (3)K0800 0 (3)K0801 0 (3)K0802 0 (3)K0806 0 (3)K0807 0 (3)K0808 0 (3)K0812 0 (3)K0813 0 (3)K0814 0 (3)K0815 0 (3)K0816 0 (3)K0820 0 (3)K0821 0 (3)K0822 0 (3)K0823 0 (3)K0824 0 (3)K0825 0 (3)K0826 0 (3)K0827 0 (3)K0828 0 (3)K0829 0 (3)K0830 0 (3)K0831 0 (3)K0835 0 (3)K0836 0 (3)K0837 0 (3)K0838 0 (3)K0839 0 (3)K0840 0 (3)K0841 0 (3)K0842 0 (3)K0843 0 (3)K0848 0 (3)K0849 0 (3)K0850 0 (3)K0851 0 (3)K0852 0 (3)K0853 0 (3)K0854 0 (3)K0855 0 (3)K0856 0 (3)K0857 0 (3)K0858 0 (3)K0859 0 (3)K0860 0 (3)K0861 0 (3)K0862 0 (3)K0863 0 (3)K0864 0 (3)K0868 0 (3)K0869 0 (3)K0870 0 (3)K0871 0 (3)K0877 0 (3)K0878 0 (3)K0879 0 (3)K0880 0 (3)K0884 0 (3)
HCPCS MUEK0885 0 (3)K0886 0 (3)K0890 0 (3)K0891 0 (3)K0898 1 (2)K0899 0 (3)K0900 0 (3)L0112 1 (2)L0113 1 (2)L0120 1 (2)L0130 1 (2)L0140 1 (2)L0150 1 (2)L0160 1 (2)L0170 1 (2)L0172 1 (2)L0174 1 (2)L0180 1 (2)L0190 1 (2)L0200 1 (2)L0220 1 (3)L0450 1 (2)L0452 1 (2)L0454 1 (2)L0455 1 (2)L0456 1 (2)L0457 1 (2)L0458 1 (2)L0460 1 (2)L0462 1 (2)L0464 1 (2)L0466 1 (2)L0467 1 (2)L0468 1 (2)L0469 1 (2)L0470 1 (2)L0472 1 (2)L0480 1 (2)L0482 1 (2)L0484 1 (2)L0486 1 (2)L0488 1 (2)L0490 1 (2)L0491 1 (2)L0492 1 (2)L0621 1 (2)L0622 1 (2)L0623 1 (2)L0624 1 (2)L0625 1 (2)L0626 1 (2)L0627 1 (2)L0628 1 (2)L0629 1 (2)L0630 1 (2)L0631 1 (2)L0632 1 (2)L0633 1 (2)L0634 1 (2)L0635 1 (2)L0636 1 (2)L0637 1 (2)L0638 1 (2)L0639 1 (2)L0640 1 (2)
HCPCS MUE
Medically Unlikely Edits (MUEs) 2019 HCPCS Level II
14 © 2018 Optum360, LLC
Med
ical
ly U
nlik
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Edit
s (M
UEs
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PPS
L0641 1 (2)L0642 1 (2)L0643 1 (2)L0648 1 (2)L0649 1 (2)L0650 1 (2)L0651 1 (2)L0700 1 (2)L0710 1 (2)L0810 1 (2)L0820 1 (2)L0830 1 (2)L0859 1 (2)L0861 1 (2)L0970 1 (2)L0972 1 (2)L0974 1 (2)L0976 1 (2)L0978 2 (3)L0980 1 (2)L0982 1 (3)L0984 3 (3)L0999 1 (3)L1000 1 (2)L1001 1 (2)L1005 1 (2)L1010 2 (2)L1020 2 (3)L1025 1 (3)L1030 1 (3)L1040 1 (3)L1050 1 (3)L1060 1 (3)L1070 2 (2)L1080 2 (2)L1085 1 (2)L1090 1 (3)L1100 2 (2)L1110 2 (2)L1120 3 (3)L1200 1 (2)L1210 2 (3)L1220 1 (3)L1230 1 (2)L1240 1 (3)L1250 2 (3)L1260 1 (3)L1270 3 (3)L1280 2 (3)L1290 2 (3)L1300 1 (2)L1310 1 (2)L1499 1 (3)L1600 1 (2)L1610 1 (2)L1620 1 (2)L1630 1 (2)L1640 1 (2)L1650 1 (2)L1652 1 (2)L1660 1 (2)L1680 1 (2)L1685 1 (2)L1686 1 (3)L1690 1 (2)
HCPCS MUEL1700 1 (2)L1710 1 (2)L1720 2 (2)L1730 1 (2)L1755 2 (2)L1810 2 (2)L1812 2 (2)L1820 2 (2)L1830 2 (2)L1831 2 (2)L1832 2 (2)L1833 2 (2)L1834 2 (2)L1836 2 (2)L1840 2 (2)L1843 2 (2)L1844 2 (2)L1845 2 (2)L1846 2 (2)L1847 2 (2)L1848 2 (2)L1850 2 (2)L1851 2 (2)L1852 2 (2)L1860 2 (2)L1900 2 (2)L1902 2 (2)L1904 2 (2)L1906 2 (2)L1907 2 (2)L1910 2 (2)L1920 2 (2)L1930 2 (2)L1932 2 (2)L1940 2 (2)L1945 2 (2)L1950 2 (2)L1951 2 (2)L1960 2 (2)L1970 2 (2)L1971 2 (2)L1980 2 (2)L1990 2 (2)L2000 2 (2)L2005 2 (2)L2010 2 (2)L2020 2 (2)L2030 2 (2)L2034 2 (2)L2035 2 (2)L2036 2 (2)L2037 2 (2)L2038 2 (2)L2040 1 (2)L2050 1 (2)L2060 1 (2)L2070 1 (2)L2080 1 (2)L2090 1 (2)L2106 2 (2)L2108 2 (2)L2112 2 (2)L2114 2 (2)L2116 2 (2)L2126 2 (2)
HCPCS MUEL2128 2 (2)L2132 2 (2)L2134 2 (2)L2136 2 (2)L2180 2 (2)L2182 4 (2)L2184 4 (2)L2186 4 (2)L2188 2 (2)L2190 2 (2)L2192 2 (2)L2200 4 (2)L2210 4 (2)L2220 4 (2)L2230 2 (2)L2232 2 (2)L2240 2 (2)L2250 2 (2)L2260 2 (2)L2265 2 (2)L2270 2 (3)L2275 2 (3)L2280 2 (2)L2300 1 (2)L2310 1 (2)L2320 2 (3)L2330 2 (3)L2335 2 (2)L2340 2 (2)L2350 2 (2)L2360 2 (2)L2370 2 (2)L2375 2 (2)L2380 2 (3)L2385 4 (2)L2387 4 (2)L2390 4 (2)L2395 4 (2)L2397 4 (3)L2405 4 (2)L2415 4 (2)L2425 4 (2)L2430 4 (2)L2492 4 (2)L2500 2 (2)L2510 2 (2)L2520 2 (2)L2525 2 (2)L2526 2 (2)L2530 2 (2)L2540 2 (2)L2550 2 (2)L2570 2 (2)L2580 2 (2)L2600 2 (2)L2610 2 (2)L2620 2 (2)L2622 2 (2)L2624 2 (2)L2627 1 (3)L2628 1 (3)L2630 1 (2)L2640 1 (2)L2650 2 (3)L2660 1 (3)
HCPCS MUEL2670 2 (3)L2680 2 (3)L2750 8 (3)L2755 8 (3)L2760 8 (2)L2768 4 (2)L2780 8 (3)L2785 4 (2)L2795 2 (2)L2800 2 (2)L2810 4 (2)L2820 2 (3)L2830 2 (3)L2861 0 (3)L2999 2 (3)L3000 2 (3)L3001 2 (3)L3002 2 (3)L3003 2 (3)L3010 2 (3)L3020 2 (3)L3030 2 (3)L3031 2 (3)L3040 2 (3)L3050 2 (3)L3060 2 (3)L3070 2 (3)L3080 2 (3)L3090 2 (3)L3100 2 (2)L3140 1 (2)L3150 1 (2)L3160 2 (2)L3170 2 (2)L3201 1 (3)L3202 1 (3)L3203 1 (3)L3204 1 (3)L3206 1 (3)L3207 1 (3)L3208 1 (3)L3209 1 (3)L3211 1 (3)L3212 1 (3)L3213 1 (3)L3214 1 (3)L3215 0 (3)L3216 0 (3)L3217 0 (3)L3219 0 (3)L3221 0 (3)L3222 0 (3)L3224 2 (2)L3225 2 (2)L3230 2 (2)L3250 2 (2)L3251 2 (2)L3252 2 (2)L3253 2 (2)L3254 1 (3)L3255 1 (3)L3257 1 (3)L3260 0 (3)L3265 1 (3)L3300 4 (3)
HCPCS MUEL3310 4 (3)L3330 2 (2)L3332 2 (2)L3334 4 (3)L3340 2 (2)L3350 2 (2)L3360 2 (2)L3370 2 (2)L3380 2 (2)L3390 2 (2)L3400 2 (2)L3410 2 (2)L3420 2 (2)L3430 2 (2)L3440 2 (2)L3450 2 (2)L3455 2 (2)L3460 2 (2)L3465 2 (2)L3470 2 (2)L3480 2 (2)L3485 2 (2)L3500 2 (2)L3510 2 (2)L3520 2 (2)L3530 2 (2)L3540 2 (2)L3550 2 (2)L3560 2 (2)L3570 2 (2)L3580 2 (2)L3590 2 (2)L3595 2 (2)L3600 2 (2)L3610 2 (2)L3620 2 (2)L3630 2 (2)L3640 1 (2)L3649 2 (3)L3650 1 (2)L3660 1 (2)L3670 1 (3)L3671 1 (3)L3674 1 (3)L3675 1 (2)L3677 1 (2)L3678 1 (2)L3702 2 (2)L3710 2 (2)L3720 2 (2)L3730 2 (2)L3740 2 (2)L3760 2 (2)L3761 2 (2)L3762 2 (2)L3763 2 (2)L3764 2 (2)L3765 2 (2)L3766 2 (2)L3806 2 (2)L3807 2 (2)L3808 2 (2)L3809 2 (2)L3891 0 (3)L3900 2 (2)
HCPCS MUEL3901 2 (2)L3904 2 (2)L3905 2 (2)L3906 2 (2)L3908 2 (2)L3912 2 (3)L3913 2 (2)L3915 2 (2)L3916 2 (3)L3917 2 (2)L3918 2 (2)L3919 2 (2)L3921 2 (2)L3923 2 (2)L3924 2 (2)L3925 4 (3)L3927 4 (3)L3929 2 (2)L3930 2 (2)L3931 2 (2)L3933 3 (3)L3935 3 (3)L3956 4 (3)L3960 1 (3)L3961 1 (3)L3962 1 (3)L3967 1 (3)L3971 1 (3)L3973 1 (3)L3975 1 (3)L3976 1 (3)L3977 1 (3)L3978 1 (3)L3980 2 (2)L3981 2 (2)L3982 2 (2)L3984 2 (2)L3999 2 (3)L4000 1 (2)L4002 4 (3)L4010 2 (2)L4020 2 (2)L4030 2 (2)L4040 2 (2)L4045 2 (2)L4050 2 (2)L4055 2 (2)L4060 2 (2)L4070 2 (3)L4080 2 (2)L4090 4 (2)L4100 2 (2)L4110 4 (2)L4130 2 (2)L4205 8 (3)L4210 4 (3)L4350 2 (2)L4360 2 (2)L4361 2 (2)L4370 2 (2)L4386 2 (2)L4387 2 (2)L4392 2 (3)L4394 2 (3)L4396 2 (2)
HCPCS MUEL4397 2 (2)L4398 2 (2)L4631 2 (2)L5000 2 (3)L5010 2 (2)L5020 2 (2)L5050 2 (2)L5060 2 (2)L5100 2 (2)L5105 2 (2)L5150 2 (2)L5160 2 (2)L5200 2 (2)L5210 2 (2)L5220 2 (2)L5230 2 (2)L5250 2 (2)L5270 2 (2)L5280 2 (2)L5301 2 (2)L5312 2 (2)L5321 2 (2)L5331 2 (2)L5341 2 (2)L5400 2 (2)L5410 2 (2)L5420 2 (2)L5430 2 (2)L5450 2 (2)L5460 2 (2)L5500 2 (2)L5505 2 (2)L5510 2 (2)L5520 2 (2)L5530 2 (2)L5535 2 (2)L5540 2 (2)L5560 2 (2)L5570 2 (2)L5580 2 (2)L5585 2 (2)L5590 2 (2)L5595 2 (2)L5600 2 (2)L5610 2 (2)L5611 2 (2)L5613 2 (2)L5614 2 (2)L5616 2 (2)L5617 2 (3)L5618 4 (3)L5620 4 (3)L5622 4 (3)L5624 4 (3)L5626 4 (3)L5628 2 (3)L5629 2 (2)L5630 2 (2)L5631 2 (2)L5632 2 (2)L5634 2 (2)L5636 2 (2)L5637 2 (2)L5638 2 (2)L5639 2 (2)
HCPCS MUEL5640 2 (2)L5642 2 (2)L5643 2 (2)L5644 2 (2)L5645 2 (2)L5646 2 (2)L5647 2 (2)L5648 2 (2)L5649 2 (2)L5650 2 (2)L5651 2 (2)L5652 2 (2)L5653 2 (2)L5654 2 (2)L5655 2 (2)L5656 2 (2)L5658 2 (2)L5661 2 (2)L5665 2 (2)L5666 2 (2)L5668 2 (2)L5670 2 (2)L5671 2 (2)L5672 2 (2)L5673 4 (3)L5676 2 (2)L5677 2 (2)L5678 2 (2)L5679 4 (3)L5680 2 (2)L5681 2 (2)L5682 2 (2)L5683 2 (2)L5684 2 (3)L5685 4 (3)L5686 2 (2)L5688 2 (3)L5690 2 (3)L5692 2 (2)L5694 2 (2)L5695 2 (3)L5696 2 (2)L5697 2 (2)L5698 2 (2)L5699 2 (3)L5700 2 (2)L5701 2 (2)L5702 2 (2)L5703 2 (2)L5704 2 (2)L5705 2 (2)L5706 2 (2)L5707 2 (2)L5710 2 (2)L5711 2 (2)L5712 2 (2)L5714 2 (2)L5716 2 (2)L5718 2 (2)L5722 2 (2)L5724 2 (2)L5726 2 (2)L5728 2 (2)L5780 2 (2)L5781 2 (2)
HCPCS MUE
2019 HCPCS Level II Medically Unlikely Edits (MUEs)
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Medically U
nlikely Edits (MU
Es)—O
PPS
L5782 2 (2)L5785 2 (2)L5790 2 (2)L5795 2 (2)L5810 2 (2)L5811 2 (2)L5812 2 (2)L5814 2 (2)L5816 2 (2)L5818 2 (2)L5822 2 (2)L5824 2 (2)L5826 2 (2)L5828 2 (2)L5830 2 (2)L5840 2 (2)L5845 2 (2)L5848 2 (2)L5850 2 (2)L5855 2 (2)L5856 2 (2)L5857 2 (2)L5858 2 (2)L5859 2 (2)L5910 2 (2)L5920 2 (2)L5925 2 (3)L5930 2 (2)L5940 2 (2)L5950 2 (2)L5960 2 (2)L5961 1 (3)L5962 2 (2)L5964 2 (2)L5966 2 (2)L5968 2 (2)L5969 0 (3)L5970 2 (2)L5971 2 (2)L5972 2 (2)L5973 2 (3)L5974 2 (2)L5975 2 (2)L5976 2 (2)L5978 2 (2)L5979 2 (2)L5980 2 (2)L5981 2 (2)L5982 2 (2)L5984 2 (2)L5985 2 (2)L5986 2 (2)L5987 2 (2)L5988 2 (2)L5990 2 (2)L5999 2 (3)L6000 2 (2)L6010 2 (2)L6020 2 (2)L6026 2 (2)L6050 2 (2)L6055 2 (2)L6100 2 (2)L6110 2 (2)L6120 2 (2)
HCPCS MUEL6130 2 (2)L6200 2 (2)L6205 2 (2)L6250 2 (2)L6300 2 (2)L6310 2 (2)L6320 2 (2)L6350 2 (2)L6360 2 (2)L6370 2 (2)L6380 2 (2)L6382 2 (2)L6384 2 (2)L6386 2 (2)L6388 2 (2)L6400 2 (2)L6450 2 (2)L6500 2 (2)L6550 2 (2)L6570 2 (2)L6580 2 (2)L6582 2 (2)L6584 2 (2)L6586 2 (2)L6588 2 (2)L6590 2 (2)L6600 2 (2)L6605 2 (2)L6610 2 (2)L6611 2 (3)L6615 2 (2)L6616 2 (2)L6620 2 (2)L6621 2 (2)L6623 2 (2)L6624 2 (2)L6625 2 (2)L6628 2 (2)L6629 2 (2)L6630 2 (2)L6632 4 (3)L6635 2 (2)L6637 2 (2)L6638 2 (2)L6640 2 (2)L6641 2 (3)L6642 2 (3)L6645 2 (2)L6646 2 (2)L6647 2 (2)L6648 2 (2)L6650 2 (2)L6655 4 (3)L6660 4 (3)L6665 4 (3)L6670 2 (2)L6672 2 (2)L6675 2 (2)L6676 2 (2)L6677 2 (2)L6680 4 (3)L6682 4 (3)L6684 4 (3)L6686 2 (2)L6687 2 (2)
HCPCS MUEL6688 2 (2)L6689 2 (2)L6690 2 (2)L6691 2 (3)L6692 2 (3)L6693 2 (2)L6694 2 (3)L6695 2 (3)L6696 2 (2)L6697 2 (2)L6698 2 (2)L6703 2 (2)L6704 2 (2)L6706 2 (2)L6707 2 (2)L6708 2 (2)L6709 2 (2)L6711 2 (2)L6712 2 (2)L6713 2 (2)L6714 2 (2)L6715 5 (3)L6721 2 (2)L6722 2 (2)L6805 2 (2)L6810 2 (3)L6880 2 (2)L6881 2 (2)L6882 2 (2)L6883 2 (2)L6884 2 (2)L6885 2 (2)L6890 2 (3)L6895 2 (3)L6900 2 (2)L6905 2 (2)L6910 2 (2)L6915 2 (2)L6920 2 (2)L6925 2 (2)L6930 2 (2)L6935 2 (2)L6940 2 (2)L6945 2 (2)L6950 2 (2)L6955 2 (2)L6960 2 (2)L6965 2 (2)L6970 2 (2)L6975 2 (2)L7007 2 (2)L7008 2 (2)L7009 2 (2)L7040 2 (2)L7045 2 (2)L7170 2 (2)L7180 2 (2)L7181 2 (2)L7185 2 (2)L7186 2 (2)L7190 2 (2)L7191 2 (2)L7259 2 (2)L7360 1 (3)L7362 1 (2)
HCPCS MUEL7364 1 (3)L7366 1 (2)L7367 2 (3)L7368 1 (2)L7400 2 (2)L7401 2 (2)L7402 2 (2)L7403 2 (2)L7404 2 (2)L7405 2 (2)L7499 2 (3)L7510 4 (3)L7600 0 (3)L7700 2 (1)L7900 0 (3)L7902 0 (3)L8000 6 (3)L8001 4 (3)L8002 4 (3)L8010 4 (3)L8015 4 (3)L8020 4 (3)L8030 2 (3)L8031 2 (3)L8032 2 (2)L8035 2 (3)L8039 2 (3)L8040 1 (2)L8041 1 (2)L8042 2 (2)L8043 1 (2)L8044 1 (2)L8045 2 (2)L8046 1 (3)L8047 1 (2)L8048 1 (3)L8049 6 (3)L8300 1 (3)L8310 1 (3)L8320 2 (3)L8330 2 (3)L8400 12 (3)L8410 12 (3)L8415 6 (3)L8417 12 (3)L8420 14 (3)L8430 12 (3)L8435 12 (3)L8440 4 (3)L8460 4 (3)L8465 4 (3)L8470 14 (3)L8480 12 (3)L8485 12 (3)L8499 1 (3)L8500 1 (2)L8501 2 (3)L8507 3 (3)L8509 1 (3)L8510 1 (2)L8511 1 (3)L8512 1 (3)L8513 1 (3)L8514 1 (3)L8515 1 (3)
HCPCS MUEL8600 2 (3)L8603 4 (3)L8604 3 (3)L8605 4 (3)L8606 5 (3)L8607 20 (3)L8609 1 (3)L8610 2 (3)L8612 1 (3)L8613 2 (3)L8614 2 (3)L8615 2 (3)L8616 2 (3)L8617 2 (3)L8618 2 (3)L8619 2 (3)L8621 360 (3)L8622 2 (3)L8625 1 (3)L8627 2 (2)L8628 2 (2)L8629 2 (2)L8631 2 (3)L8641 4 (3)L8642 2 (3)L8658 3 (3)L8659 4 (3)L8670 3 (3)L8679 3 (3)L8680 0 (3)L8681 1 (3)L8682 2 (3)L8683 1 (3)L8684 1 (3)L8685 0 (3)L8686 0 (3)L8687 0 (3)L8688 0 (3)L8689 1 (3)L8690 2 (2)L8691 1 (3)L8692 0 (3)L8693 1 (3)L8694 1 (3)L8695 1 (3)L8696 1 (3)M0075 0 (3)M0076 0 (3)M0100 0 (3)M0300 0 (3)M0301 0 (3)P2028 1 (2)P2029 1 (2)P2031 0 (3)P2033 1 (2)P2038 1 (2)P3000 1 (3)P3001 1 (3)P7001 0 (3)P9010 4 (3)P9011 4 (3)P9012 12 (3)P9016 12 (3)P9017 24 (3)P9019 12 (3)
HCPCS MUEP9020 5 (3)P9021 8 (3)P9022 12 (3)P9023 15 (3)P9031 12 (3)P9032 12 (3)P9033 12 (3)P9034 4 (3)P9035 4 (3)P9036 4 (3)P9037 4 (3)P9038 4 (3)P9039 2 (3)P9040 8 (3)P9041 100 (3)P9043 10 (3)P9044 20 (3)P9045 20 (3)P9046 40 (3)P9047 20 (3)P9048 2 (3)P9050 1 (3)P9051 4 (3)P9052 3 (3)P9053 3 (3)P9054 2 (3)P9055 2 (3)P9056 3 (3)P9057 4 (3)P9058 4 (3)P9059 15 (3)P9060 4 (3)P9070 15 (3)P9071 15 (3)P9073 4 (3)P9100 12 (3)P9603 100 (3)P9604 2 (3)P9612 1 (3)P9615 1 (3)Q0035 1 (3)Q0081 2 (3)Q0083 2 (3)Q0084 2 (3)Q0085 2 (3)Q0091 1 (3)Q0092 2 (3)Q0111 2 (3)Q0112 3 (3)Q0113 1 (3)Q0114 1 (3)Q0115 1 (3)Q0138 510 (3)Q0139 510 (3)Q0144 0 (3)Q0161 66 (3)Q0162 24 (3)Q0163 6 (3)Q0164 8 (3)Q0166 2 (3)Q0167 108 (3)Q0169 12 (3)Q0173 5 (3)Q0174 0 (3)Q0175 6 (3)
HCPCS MUEQ0177 16 (3)Q0180 1 (3)Q0181 2 (3)Q0477 1 (1)Q0478 1 (3)Q0479 1 (3)Q0480 1 (3)Q0481 1 (2)Q0482 1 (3)Q0483 1 (3)Q0484 1 (3)Q0485 1 (3)Q0486 1 (3)Q0487 1 (3)Q0488 1 (3)Q0489 1 (3)Q0490 1 (3)Q0491 1 (3)Q0492 1 (3)Q0493 1 (3)Q0494 1 (3)Q0495 1 (3)Q0497 2 (3)Q0498 1 (3)Q0499 1 (3)Q0501 1 (3)Q0502 1 (3)Q0503 3 (3)Q0504 1 (3)Q0506 8 (3)Q0507 1 (3)Q0508 24 (3)Q0509 2 (3)Q0510 1 (2)Q0511 1 (2)Q0512 4 (3)Q0513 1 (2)Q0514 1 (2)Q0515 0 (3)Q1004 0 (3)Q1005 0 (3)Q2004 1 (3)Q2009 100 (3)Q2017 12 (3)Q2026 0 (3)Q2028 0 (3)Q2034 1 (2)Q2035 1 (2)Q2036 1 (2)Q2037 1 (2)Q2038 1 (2)Q2039 1 (2)Q2043 1 (2)Q2049 0 (3)Q2050 20 (3)Q2052 0 (3)Q3014 2 (3)Q3027 30 (3)Q3028 0 (3)Q3031 1 (3)Q4001 1 (3)Q4002 1 (3)Q4003 2 (3)Q4004 2 (3)Q4025 1 (3)
HCPCS MUEQ4026 1 (3)Q4027 1 (3)Q4028 1 (3)Q4050 2 (3)Q4051 2 (3)Q4074 0 (3)Q4081 400 (3)Q4101 176 (3)Q4102 140 (3)Q4103 0 (3)Q4104 250 (3)Q4105 250 (3)Q4106 76 (3)Q4107 128 (3)Q4108 250 (3)Q4110 250 (3)Q4111 112 (3)Q4112 2 (3)Q4113 4 (3)Q4114 6 (3)Q4115 240 (3)Q4116 640 (3)Q4117 200 (3)Q4118 1000 (3)Q4121 156 (3)Q4122 96 (3)Q4123 160 (3)Q4124 280 (3)Q4125 28 (3)Q4126 32 (3)Q4127 100 (3)Q4128 840 (3)Q4130 160 (3)Q4132 50 (3)Q4133 113 (3)Q4134 160 (3)Q4135 900 (3)Q4136 900 (3)Q4137 32 (3)Q4138 32 (3)Q4139 2 (3)Q4140 32 (3)Q4141 25 (3)Q4142 600 (3)Q4143 96 (3)Q4145 160 (3)Q4146 50 (3)Q4147 150 (3)Q4148 24 (3)Q4149 10 (3)Q4150 32 (3)Q4151 98 (3)Q4152 24 (3)Q4153 6 (3)Q4154 36 (3)Q4155 100 (3)Q4156 49 (3)Q4157 24 (3)Q4158 70 (3)Q4159 14 (3)Q4160 72 (3)Q4161 42 (3)Q4162 4 (3)Q4163 32 (3)Q4164 400 (3)
HCPCS MUE
Medically Unlikely Edits (MUEs) 2019 HCPCS Level II
16 © 2018 Optum360, LLC
Med
ical
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s (M
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PPS
Q4165 100 (3)Q4166 300 (3)Q4167 32 (3)Q4168 160 (3)Q4169 32 (3)Q4170 120 (3)Q4171 100 (3)Q4173 64 (3)Q4174 8 (3)Q4175 120 (3)Q5101 1500 (3)Q5103 150 (3)Q5104 150 (3)Q5105 400 (3)Q5106 60 (3)Q5108 12 (3)Q9950 5 (3)Q9951 0 (3)Q9953 10 (3)Q9954 18 (3)Q9955 0 (3)Q9956 9 (3)Q9957 3 (3)Q9958 600 (3)Q9959 0 (3)Q9960 250 (3)Q9961 200 (3)Q9962 200 (3)Q9963 240 (3)Q9964 0 (3)
HCPCS MUEQ9966 250 (3)Q9967 300 (3)Q9969 3 (3)Q9982 1 (3)Q9983 1 (3)Q9991 1 (3)Q9992 1 (3)R0070 2 (3)R0075 2 (3)R0076 1 (3)V2020 1 (3)V2025 0 (3)V2100 2 (3)V2101 2 (3)V2102 2 (3)V2103 2 (3)V2104 2 (3)V2105 2 (3)V2106 2 (3)V2107 2 (3)V2108 2 (3)V2109 2 (3)V2110 2 (3)V2111 2 (3)V2112 2 (3)V2113 2 (3)V2114 2 (3)V2115 2 (3)V2118 2 (3)V2121 2 (3)
HCPCS MUEV2199 2 (3)V2200 2 (3)V2201 2 (3)V2202 2 (3)V2203 2 (3)V2204 2 (3)V2205 2 (3)V2206 2 (3)V2207 2 (3)V2208 2 (3)V2209 2 (3)V2210 2 (3)V2211 2 (3)V2212 2 (3)V2213 2 (3)V2214 2 (3)V2215 2 (3)V2218 2 (3)V2219 2 (3)V2220 2 (3)V2221 2 (3)V2299 2 (3)V2300 2 (3)V2301 2 (3)V2302 2 (3)V2303 2 (3)V2304 2 (3)V2305 2 (3)V2306 2 (3)V2307 2 (3)
HCPCS MUEV2308 2 (3)V2309 2 (3)V2310 2 (3)V2311 2 (3)V2312 2 (3)V2313 2 (3)V2314 2 (3)V2315 2 (3)V2318 2 (3)V2319 2 (3)V2320 2 (3)V2321 2 (3)V2399 2 (3)V2410 2 (3)V2430 2 (3)V2499 2 (3)V2500 2 (3)V2501 2 (3)V2502 2 (3)V2503 2 (3)V2510 2 (3)V2511 2 (3)V2512 2 (3)V2513 2 (3)V2520 2 (3)V2521 2 (3)V2522 2 (3)V2523 2 (3)V2530 2 (3)V2531 2 (3)
HCPCS MUEV2599 2 (3)V2600 0 (2)V2610 0 (2)V2615 0 (2)V2623 2 (2)V2624 2 (2)V2625 2 (2)V2626 2 (2)V2627 2 (2)V2628 2 (3)V2629 2 (2)V2630 2 (2)V2631 2 (2)V2632 2 (2)V2700 2 (3)V2702 0 (3)V2710 2 (3)V2715 4 (3)V2718 2 (3)V2730 2 (3)V2744 2 (3)V2745 2 (3)V2750 2 (3)V2755 2 (3)V2756 0 (3)V2760 0 (3)V2761 0 (2)V2762 0 (3)V2770 2 (3)V2780 2 (3)
HCPCS MUEV2781 0 (2)V2782 2 (3)V2783 2 (3)V2784 2 (3)V2785 2 (2)V2786 0 (3)V2787 0 (3)V2788 0 (3)V2790 1 (3)V2797 0 (3)V5008 0 (3)V5010 0 (3)V5011 0 (3)V5014 0 (3)V5020 0 (3)V5030 0 (3)V5040 0 (3)V5050 0 (3)V5060 0 (3)V5070 0 (3)V5080 0 (3)V5090 0 (3)V5095 0 (3)V5100 0 (3)V5110 0 (3)V5120 0 (3)V5130 0 (3)V5140 0 (3)V5150 0 (3)V5160 0 (3)
HCPCS MUEV5190 0 (3)V5200 0 (3)V5230 0 (3)V5240 0 (3)V5241 0 (3)V5242 0 (3)V5243 0 (3)V5244 0 (3)V5245 0 (3)V5246 0 (3)V5247 0 (3)V5248 0 (3)V5249 0 (3)V5250 0 (3)V5251 0 (3)V5252 0 (3)V5253 0 (3)V5254 0 (3)V5255 0 (3)V5256 0 (3)V5257 0 (3)V5258 0 (3)V5259 0 (3)V5260 0 (3)V5261 0 (3)V5262 0 (3)V5263 0 (3)V5264 0 (3)V5265 0 (3)V5266 0 (3)
HCPCS MUEV5267 0 (3)V5268 0 (3)V5269 0 (3)V5270 0 (3)V5271 0 (3)V5272 0 (3)V5273 0 (3)V5274 0 (3)V5275 0 (3)V5281 0 (3)V5282 0 (3)V5283 0 (3)V5284 0 (3)V5285 0 (3)V5286 0 (3)V5287 0 (3)V5288 0 (3)V5289 0 (3)V5290 0 (3)V5298 0 (3)V5299 1 (3)V5336 0 (3)V5362 0 (3)V5363 0 (3)V5364 0 (3)
HCPCS MUE
2019 HCPCS Level II Medically Unlikely Edits (MUEs)
© 2018 Optum360, LLC 17
Medically U
nlikely Edits (MU
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ME
DME
HCPCS MUEA4206 0 (3)A4207 0 (3)A4208 0 (3)A4209 0 (3)A4210 0 (3)A4211 0 (3)A4213 0 (3)A4215 0 (3)A4221 4 (3)A4223 0 (3)A4230 0 (3)A4231 0 (3)A4232 0 (3)A4233 2 (3)A4234 2 (3)A4235 2 (3)A4236 2 (3)A4244 0 (3)A4245 0 (3)A4246 0 (3)A4247 0 (3)A4248 0 (3)A4250 0 (3)A4252 0 (3)A4253 1 (3)A4255 0 (3)A4256 2 (3)A4257 0 (3)A4258 1 (2)A4259 1 (3)A4281 0 (3)A4282 0 (3)A4283 0 (3)A4284 0 (3)A4285 0 (3)A4286 0 (3)A4305 0 (3)A4306 0 (3)A4310 3 (3)A4311 3 (3)A4312 3 (3)A4313 3 (3)A4314 3 (3)A4315 3 (3)A4316 3 (3)A4321 0 (3)A4330 0 (3)A4331 6 (3)A4332 600 (3)A4334 3 (3)A4336 1 (3)A4337 0 (3)A4338 3 (3)A4340 3 (3)A4344 3 (3)A4346 3 (3)A4354 3 (3)A4356 1 (2)A4357 6 (3)A4358 6 (3)A4360 0 (3)A4361 2 (3)A4363 6 (3)A4367 3 (3)
A4384 4 (3)A4396 3 (3)A4398 1 (3)A4399 1 (3)A4400 0 (3)A4458 0 (3)A4459 1 (3)A4463 3 (3)A4465 0 (3)A4467 0 (3)A4470 0 (3)A4480 0 (3)A4490 0 (3)A4495 0 (3)A4500 0 (3)A4510 0 (3)A4520 0 (3)A4553 0 (3)A4554 0 (3)A4555 0 (3)A4556 0 (3)A4557 2 (3)A4558 0 (3)A4561 0 (3)A4562 0 (3)A4575 0 (3)A4595 6 (3)A4600 0 (3)A4601 1 (3)A4602 6 (3)A4604 1 (2)A4606 0 (3)A4608 0 (3)A4611 2 (3)A4612 2 (3)A4613 1 (3)A4614 1 (2)A4615 0 (3)A4616 0 (3)A4617 0 (3)A4619 3 (3)A4620 0 (3)A4623 200 (3)A4625 100 (3)A4626 6 (3)A4627 0 (3)A4630 0 (3)A4633 6 (3)A4634 0 (3)A4635 2 (2)A4636 2 (2)A4637 4 (2)A4638 2 (3)A4639 0 (3)A4640 1 (2)A4650 0 (3)A4651 0 (3)A4652 0 (3)A4653 0 (3)A4657 0 (3)A4660 0 (3)A4663 0 (3)A4670 0 (3)A4671 0 (3)
HCPCS MUEA4672 0 (3)A4673 0 (3)A4674 0 (3)A4680 0 (3)A4690 0 (3)A4706 0 (3)A4707 0 (3)A4708 0 (3)A4709 0 (3)A4714 0 (3)A4719 0 (3)A4720 0 (3)A4721 0 (3)A4722 0 (3)A4723 0 (3)A4724 0 (3)A4725 0 (3)A4726 0 (3)A4728 0 (3)A4730 0 (3)A4736 0 (3)A4737 0 (3)A4740 0 (3)A4750 0 (3)A4755 0 (3)A4760 0 (3)A4765 0 (3)A4766 0 (3)A4770 0 (3)A4771 0 (3)A4772 0 (3)A4773 0 (3)A4774 0 (3)A4802 0 (3)A4860 0 (3)A4870 0 (3)A4890 0 (3)A4911 0 (3)A4913 0 (3)A4918 0 (3)A4927 0 (3)A4928 0 (3)A4929 0 (3)A4930 0 (3)A4931 0 (3)A4932 0 (3)A5056 120 (3)A5057 120 (3)A5082 3 (3)A5102 1 (3)A5105 4 (3)A5112 3 (3)A5113 3 (3)A5114 3 (3)A5120 450 (3)A5131 3 (3)A5500 2 (2)A5501 2 (2)A5503 2 (2)A5504 2 (2)A5505 2 (2)A5506 2 (2)A5507 2 (3)A5508 0 (3)
HCPCS MUEA5510 0 (3)A5512 6 (2)A5513 6 (2)A6000 0 (3)A6025 0 (3)A6228 0 (3)A6229 0 (3)A6230 0 (3)A6250 0 (3)A6260 0 (3)A6411 2 (3)A6412 1 (3)A6413 0 (3)A6501 2 (2)A6502 2 (2)A6503 2 (2)A6504 4 (2)A6505 4 (2)A6506 4 (2)A6507 4 (2)A6508 4 (2)A6509 2 (2)A6510 2 (2)A6511 2 (2)A6513 2 (2)A6530 0 (3)A6531 4 (3)A6532 4 (3)A6533 0 (3)A6534 0 (3)A6535 0 (3)A6536 0 (3)A6537 0 (3)A6538 0 (3)A6539 0 (3)A6540 0 (3)A6541 0 (3)A6544 0 (3)A6545 2 (3)A6549 0 (3)A7001 3 (3)A7003 6 (2)A7004 6 (2)A7005 1 (2)A7006 3 (2)A7007 6 (2)A7008 0 (3)A7009 2 (3)A7010 2 (2)A7012 6 (2)A7013 6 (2)A7014 1 (2)A7015 3 (2)A7016 1 (2)A7017 1 (2)A7020 1 (3)A7025 1 (3)A7026 1 (3)A7027 1 (2)A7028 6 (2)A7029 6 (2)A7030 1 (2)A7031 3 (2)A7032 6 (2)
HCPCS MUEA7033 6 (2)A7034 1 (2)A7035 1 (2)A7036 1 (2)A7037 1 (2)A7038 6 (2)A7039 1 (2)A7040 0 (3)A7041 0 (3)A7044 1 (3)A7045 2 (3)A7046 1 (2)A7047 0 (3)A7048 0 (3)A7501 3 (3)A7502 3 (3)A7503 1 (3)A7504 200 (3)A7505 2 (3)A7506 200 (3)A7507 200 (3)A7508 200 (3)A7509 200 (3)A7520 1 (3)A7521 1 (3)A7522 1 (2)A7523 0 (3)A7524 1 (3)A7525 3 (2)A7526 100 (3)A7527 2 (3)A8000 0 (3)A8001 0 (3)A8002 0 (3)A8003 0 (3)A8004 0 (3)A9270 0 (3)A9272 0 (3)A9273 0 (3)A9274 0 (3)A9275 0 (3)A9276 0 (3)A9277 0 (3)A9278 0 (3)A9279 0 (3)A9280 0 (3)A9281 0 (3)A9282 0 (3)A9283 0 (3)A9284 0 (3)A9285 0 (3)A9286 0 (3)A9300 0 (3)A9559 0 (3)A9901 0 (3)B4034 1 (1)B4035 1 (1)B4036 1 (1)B4100 0 (3)B4102 0 (3)B4103 0 (3)B4104 0 (3)B4164 2 (1)B4168 2 (1)
HCPCS MUEB4172 2 (1)B4176 2 (1)B4178 2 (1)B4180 1 (1)B4189 1 (1)B4193 1 (1)B4197 1 (1)B4199 1 (1)B4216 1 (1)B4220 1 (1)B4222 1 (1)B4224 1 (1)B9002 1 (1)B9004 1 (1)B9006 1 (1)E0100 1 (3)E0105 1 (3)E0110 1 (2)E0111 2 (2)E0112 1 (2)E0113 2 (2)E0114 1 (2)E0116 2 (2)E0117 2 (2)E0118 1 (2)E0130 1 (2)E0135 1 (2)E0140 1 (2)E0141 1 (2)E0143 1 (2)E0144 1 (2)E0147 1 (2)E0148 1 (2)E0149 1 (2)E0153 2 (2)E0154 2 (2)E0155 1 (3)E0156 1 (2)E0157 2 (2)E0158 1 (2)E0159 2 (2)E0160 1 (2)E0161 1 (2)E0162 1 (2)E0163 1 (2)E0165 1 (2)E0167 1 (2)E0168 1 (2)E0170 1 (2)E0171 1 (2)E0172 0 (3)E0175 2 (2)E0181 1 (2)E0182 1 (2)E0184 1 (2)E0185 1 (2)E0186 1 (2)E0187 1 (2)E0188 1 (3)E0189 1 (3)E0190 0 (3)E0191 0 (3)E0193 1 (2)E0194 1 (2)
HCPCS MUEE0196 1 (2)E0197 1 (2)E0198 1 (2)E0199 1 (2)E0200 0 (3)E0202 1 (2)E0203 0 (3)E0205 0 (3)E0210 1 (2)E0215 0 (3)E0217 0 (3)E0218 1 (2)E0221 0 (3)E0225 0 (3)E0231 0 (3)E0232 0 (3)E0235 1 (2)E0236 0 (3)E0239 0 (3)E0240 0 (3)E0241 0 (3)E0242 0 (3)E0243 0 (3)E0244 0 (3)E0245 0 (3)E0246 0 (3)E0247 0 (3)E0248 0 (3)E0249 0 (3)E0250 1 (2)E0251 1 (2)E0255 1 (2)E0256 1 (2)E0260 1 (2)E0261 1 (2)E0265 1 (2)E0266 1 (2)E0270 1 (2)E0271 1 (2)E0272 1 (2)E0273 0 (3)E0274 0 (3)E0275 1 (2)E0276 1 (2)E0277 1 (2)E0280 1 (2)E0290 1 (2)E0291 1 (2)E0292 1 (2)E0293 1 (2)E0294 1 (2)E0295 1 (2)E0296 1 (2)E0297 1 (2)E0300 1 (2)E0301 1 (2)E0302 1 (2)E0303 1 (2)E0304 1 (2)E0305 2 (3)E0310 2 (2)E0315 0 (3)E0316 1 (2)E0325 1 (2)
HCPCS MUEE0326 1 (2)E0328 1 (2)E0329 1 (2)E0350 1 (2)E0352 30 (3)E0370 0 (3)E0371 1 (2)E0372 1 (2)E0373 1 (2)E0424 1 (2)E0425 0 (3)E0430 0 (3)E0431 1 (2)E0433 1 (2)E0434 1 (2)E0435 0 (3)E0439 1 (2)E0440 0 (3)E0441 1 (2)E0442 1 (2)E0443 1 (2)E0444 1 (2)E0445 0 (3)E0446 0 (3)E0455 0 (3)E0457 1 (3)E0459 1 (3)E0462 1 (2)E0465 2 (3)E0466 2 (3)E0470 1 (3)E0471 1 (3)E0472 1 (3)E0480 1 (2)E0481 1 (2)E0482 1 (2)E0483 1 (2)E0484 1 (2)E0485 1 (2)E0486 1 (2)E0487 0 (3)E0500 1 (2)E0550 1 (2)E0555 1 (2)E0560 1 (2)E0561 1 (3)E0562 1 (3)E0565 1 (3)E0570 1 (3)E0572 1 (3)E0574 1 (3)E0575 1 (3)E0580 1 (3)E0585 1 (3)E0600 1 (2)E0601 1 (3)E0602 1 (2)E0603 1 (2)E0604 1 (2)E0605 1 (2)E0606 1 (2)E0607 1 (2)E0610 1 (2)E0615 1 (2)
HCPCS MUE
Medically Unlikely Edits (MUEs) 2019 HCPCS Level II
18 © 2018 Optum360, LLC
Med
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E0616 0 (3)E0617 1 (2)E0618 1 (2)E0619 1 (2)E0620 1 (2)E0621 1 (2)E0625 0 (3)E0627 1 (2)E0629 1 (2)E0630 1 (2)E0635 1 (2)E0636 1 (2)E0637 1 (2)E0638 0 (3)E0639 1 (2)E0640 1 (2)E0641 0 (3)E0642 0 (3)E0650 1 (3)E0651 1 (3)E0652 1 (3)E0655 2 (2)E0656 0 (3)E0657 0 (3)E0660 2 (2)E0665 2 (2)E0666 2 (2)E0667 2 (2)E0668 2 (2)E0669 2 (2)E0670 0 (3)E0671 2 (2)E0672 2 (2)E0673 2 (2)E0675 1 (2)E0676 1 (3)E0691 1 (2)E0692 1 (2)E0693 1 (2)E0694 1 (2)E0700 0 (3)E0705 1 (2)E0710 0 (3)E0720 1 (2)E0730 1 (2)E0731 1 (3)E0740 1 (2)E0744 1 (2)E0745 1 (3)E0746 0 (3)E0747 1 (3)E0748 1 (3)E0749 0 (3)E0755 1 (2)E0760 1 (3)E0761 0 (3)E0762 1 (3)E0764 1 (2)E0765 1 (2)E0766 0 (3)E0769 0 (3)E0770 1 (3)E0776 1 (3)E0779 1 (3)E0780 1 (3)
HCPCS MUEE0781 1 (2)E0782 0 (3)E0783 0 (3)E0784 1 (2)E0785 0 (3)E0786 0 (3)E0791 1 (2)E0830 0 (3)E0840 1 (2)E0849 1 (2)E0850 1 (2)E0855 1 (2)E0856 1 (2)E0860 1 (2)E0870 1 (2)E0880 1 (2)E0890 1 (2)E0900 1 (2)E0910 1 (2)E0911 1 (2)E0912 1 (2)E0920 1 (2)E0930 1 (2)E0935 21 (3)E0936 0 (3)E0940 1 (2)E0941 1 (2)E0942 1 (2)E0944 1 (3)E0945 2 (3)E0946 1 (2)E0947 1 (2)E0948 1 (2)E0950 1 (2)E0951 2 (2)E0952 2 (2)E0953 4 (3)E0954 2 (2)E0955 1 (2)E0956 4 (3)E0957 2 (3)E0958 1 (3)E0959 2 (2)E0960 2 (2)E0961 2 (2)E0966 1 (2)E0967 2 (2)E0968 1 (2)E0969 0 (3)E0970 2 (2)E0971 2 (3)E0973 2 (2)E0974 2 (2)E0978 1 (3)E0980 0 (3)E0981 1 (2)E0982 1 (2)E0983 0 (3)E0984 0 (3)E0985 1 (2)E0986 1 (2)E0988 1 (2)E0990 2 (2)E0992 1 (2)E0994 2 (2)
HCPCS MUEE0995 2 (2)E1002 1 (2)E1003 1 (2)E1004 1 (2)E1005 1 (2)E1006 1 (2)E1007 1 (2)E1008 1 (2)E1009 2 (2)E1010 1 (2)E1011 1 (2)E1012 1 (3)E1014 1 (2)E1015 2 (3)E1016 2 (3)E1017 2 (3)E1018 2 (3)E1020 2 (2)E1028 6 (3)E1029 1 (2)E1030 1 (2)E1031 1 (2)E1035 1 (2)E1036 1 (2)E1037 1 (2)E1038 1 (2)E1039 1 (2)E1050 1 (2)E1060 1 (2)E1070 1 (2)E1083 1 (2)E1084 1 (2)E1085 1 (2)E1086 1 (2)E1087 1 (2)E1088 1 (2)E1089 1 (2)E1090 1 (2)E1092 1 (2)E1093 1 (2)E1100 1 (2)E1110 1 (2)E1130 1 (2)E1140 1 (2)E1150 1 (2)E1160 1 (2)E1161 1 (2)E1170 1 (2)E1171 1 (2)E1172 1 (2)E1180 1 (2)E1190 1 (2)E1195 1 (2)E1200 1 (2)E1220 1 (2)E1221 1 (2)E1222 1 (2)E1223 1 (2)E1224 1 (2)E1225 1 (2)E1226 1 (2)E1227 0 (3)E1228 1 (2)E1229 1 (2)E1230 1 (2)
HCPCS MUEE1231 1 (2)E1232 1 (2)E1233 1 (2)E1234 1 (2)E1235 1 (2)E1236 1 (2)E1237 1 (2)E1238 1 (2)E1239 1 (2)E1240 1 (2)E1250 1 (2)E1260 1 (2)E1270 1 (2)E1280 1 (2)E1285 1 (2)E1290 1 (2)E1295 1 (2)E1296 0 (3)E1297 0 (3)E1298 0 (3)E1300 0 (3)E1310 1 (2)E1352 0 (3)E1353 0 (3)E1354 0 (3)E1355 0 (3)E1356 0 (3)E1357 0 (3)E1358 0 (3)E1372 1 (3)E1390 1 (2)E1391 1 (2)E1392 1 (2)E1405 1 (2)E1406 1 (2)E1500 0 (3)E1510 0 (3)E1520 0 (3)E1530 0 (3)E1540 0 (3)E1550 0 (3)E1560 0 (3)E1570 0 (3)E1575 0 (3)E1580 0 (3)E1590 0 (3)E1592 0 (3)E1594 0 (3)E1600 0 (3)E1610 0 (3)E1615 0 (3)E1620 0 (3)E1625 0 (3)E1630 0 (3)E1632 0 (3)E1634 0 (3)E1635 0 (3)E1636 0 (3)E1637 0 (3)E1639 0 (3)E1700 1 (2)E1701 3 (3)E1702 0 (3)E1800 2 (3)E1801 2 (3)
HCPCS MUEE1802 2 (3)E1805 2 (3)E1806 2 (3)E1810 2 (3)E1811 2 (3)E1812 2 (3)E1815 2 (3)E1816 2 (3)E1818 2 (3)E1820 2 (3)E1821 1 (3)E1825 3 (3)E1830 2 (3)E1831 2 (3)E1840 2 (3)E1841 2 (3)E1902 1 (3)E2000 1 (2)E2100 1 (2)E2101 1 (2)E2120 1 (2)E2201 1 (2)E2202 1 (2)E2203 1 (2)E2204 1 (2)E2205 2 (2)E2206 2 (2)E2207 2 (2)E2208 1 (3)E2209 2 (2)E2210 12 (3)E2211 2 (2)E2212 2 (2)E2213 2 (2)E2214 2 (3)E2215 2 (3)E2216 2 (2)E2217 2 (3)E2218 2 (2)E2219 2 (3)E2220 2 (2)E2221 2 (3)E2222 2 (3)E2224 2 (2)E2225 2 (3)E2226 2 (3)E2227 2 (2)E2228 2 (2)E2230 0 (3)E2231 1 (2)E2291 1 (2)E2292 1 (2)E2293 1 (2)E2294 1 (2)E2295 1 (2)E2300 1 (2)E2301 1 (2)E2310 1 (2)E2311 1 (2)E2312 1 (2)E2313 1 (2)E2321 1 (2)E2322 1 (3)E2323 1 (2)E2324 1 (2)
HCPCS MUEE2325 1 (2)E2326 1 (3)E2327 1 (2)E2328 1 (2)E2329 1 (2)E2330 1 (2)E2331 1 (2)E2340 1 (2)E2341 1 (2)E2342 1 (2)E2343 1 (2)E2351 1 (2)E2358 2 (2)E2359 2 (2)E2360 0 (3)E2361 2 (2)E2362 0 (3)E2363 2 (2)E2364 0 (3)E2365 2 (2)E2366 1 (2)E2367 1 (2)E2368 2 (2)E2369 2 (2)E2370 2 (2)E2371 2 (2)E2372 0 (3)E2373 1 (2)E2374 1 (2)E2375 1 (2)E2376 1 (2)E2377 1 (2)E2378 2 (3)E2381 2 (2)E2382 2 (2)E2383 2 (2)E2384 4 (2)E2385 4 (2)E2386 2 (2)E2387 4 (2)E2388 2 (2)E2389 4 (2)E2390 2 (2)E2391 4 (2)E2392 4 (2)E2394 2 (2)E2395 4 (2)E2396 4 (2)E2397 1 (3)E2402 1 (2)E2500 1 (2)E2502 1 (2)E2504 1 (2)E2506 1 (2)E2508 1 (2)E2510 1 (2)E2511 1 (2)E2512 1 (3)E2601 1 (2)E2602 1 (2)E2603 1 (2)E2604 1 (2)E2605 1 (2)E2606 1 (2)E2607 1 (2)
HCPCS MUEE2608 1 (2)E2609 1 (2)E2610 0 (3)E2611 1 (2)E2612 1 (2)E2613 1 (2)E2614 1 (2)E2615 1 (2)E2616 1 (2)E2617 1 (2)E2619 2 (2)E2620 1 (2)E2621 1 (2)E2622 1 (2)E2623 1 (2)E2624 1 (2)E2625 1 (2)E2626 2 (2)E2627 2 (2)E2628 2 (2)E2629 2 (2)E2630 2 (2)E2631 2 (2)E2632 2 (2)E2633 2 (2)E8000 0 (3)E8001 0 (3)E8002 0 (3)G0333 1 (2)J0120 0 (3)J0129 0 (3)J0130 0 (3)J0131 0 (3)J0132 0 (3)J0133 3600 (3)J0135 0 (3)J0153 0 (3)J0171 0 (3)J0178 0 (3)J0180 0 (3)J0190 0 (3)J0200 0 (3)J0202 0 (3)J0205 0 (3)J0207 0 (3)J0210 0 (3)J0215 0 (3)J0220 0 (3)J0221 0 (3)J0256 0 (3)J0257 0 (3)J0270 0 (3)J0275 0 (3)J0278 0 (3)J0280 0 (3)J0282 0 (3)J0285 30 (3)J0287 300 (3)J0288 0 (3)J0289 150 (3)J0290 0 (3)J0295 0 (3)J0300 0 (3)J0330 0 (3)J0348 0 (3)
HCPCS MUEJ0350 0 (3)J0360 0 (3)J0364 0 (3)J0365 0 (3)J0380 0 (3)J0390 0 (3)J0395 0 (3)J0400 0 (3)J0401 0 (3)J0456 0 (3)J0461 0 (3)J0470 0 (3)J0475 0 (3)J0476 0 (3)J0480 0 (3)J0485 0 (3)J0490 0 (3)J0500 0 (3)J0515 0 (3)J0520 0 (3)J0558 0 (3)J0561 0 (3)J0565 0 (3)J0570 0 (3)J0571 0 (3)J0572 0 (3)J0573 0 (3)J0574 0 (3)J0575 0 (3)J0583 0 (3)J0585 0 (3)J0586 0 (3)J0587 0 (3)J0588 0 (3)J0592 0 (3)J0594 0 (3)J0595 0 (3)J0596 0 (3)J0597 0 (3)J0598 0 (3)J0600 0 (3)J0604 0 (3)J0606 0 (3)J0610 0 (3)J0620 0 (3)J0630 0 (3)J0636 0 (3)J0637 0 (3)J0638 0 (3)J0640 0 (3)J0641 0 (3)J0670 0 (3)J0690 0 (3)J0692 0 (3)J0694 0 (3)J0695 0 (3)J0696 0 (3)J0697 0 (3)J0698 0 (3)J0702 0 (3)J0706 0 (3)J0710 0 (3)J0712 0 (3)J0713 0 (3)J0714 0 (3)
HCPCS MUE
2019 HCPCS Level II Medically Unlikely Edits (MUEs)
© 2018 Optum360, LLC 19
Medically U
nlikely Edits (MU
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J0715 0 (3)J0716 0 (3)J0717 0 (3)J0720 0 (3)J0725 0 (3)J0735 0 (3)J0740 0 (3)J0743 0 (3)J0744 0 (3)J0745 0 (3)J0770 0 (3)J0775 0 (3)J0780 0 (3)J0795 0 (3)J0800 0 (3)J0834 0 (3)J0840 0 (3)J0850 0 (3)J0875 0 (3)J0878 0 (3)J0881 0 (3)J0882 0 (3)J0883 0 (3)J0884 0 (3)J0885 0 (3)J0887 0 (3)J0888 0 (3)J0890 0 (3)J0894 0 (3)J0895 212 (3)J0897 0 (3)J0945 0 (3)J1000 0 (3)J1020 0 (3)J1030 0 (3)J1040 0 (3)J1050 0 (3)J1071 0 (3)J1094 0 (3)J1100 0 (3)J1110 0 (3)J1120 0 (3)J1130 0 (3)J1160 0 (3)J1162 0 (3)J1165 0 (3)J1170 2500 (3)J1180 0 (3)J1190 0 (3)J1200 0 (3)J1205 0 (3)J1212 0 (3)J1230 0 (3)J1240 0 (3)J1245 0 (3)J1250 60 (3)J1260 0 (3)J1265 230 (3)J1267 0 (3)J1270 0 (3)J1290 0 (3)J1300 0 (3)J1320 0 (3)J1322 0 (3)J1324 0 (3)
HCPCS MUEJ1325 810 (3)J1327 0 (3)J1330 0 (3)J1335 0 (3)J1364 0 (3)J1380 0 (3)J1410 0 (3)J1428 0 (3)J1430 0 (3)J1435 0 (3)J1436 0 (3)J1438 0 (3)J1439 0 (3)J1442 0 (3)J1443 0 (3)J1447 0 (3)J1450 0 (3)J1451 0 (3)J1452 0 (3)J1453 0 (3)J1455 90 (3)J1457 0 (3)J1458 0 (3)J1459 300 (3)J1460 0 (3)J1555 1500 (3)J1556 300 (3)J1557 300 (3)J1559 1500 (3)J1560 0 (3)J1561 300 (3)J1562 0 (3)J1566 300 (3)J1568 300 (3)J1569 300 (3)J1570 18 (3)J1571 0 (3)J1572 300 (3)J1573 0 (3)J1575 900 (3)J1580 0 (3)J1595 0 (3)J1599 300 (3)J1600 0 (3)J1602 0 (3)J1610 0 (3)J1620 0 (3)J1626 0 (3)J1627 0 (3)J1630 0 (3)J1631 0 (3)J1640 0 (3)J1642 0 (3)J1644 0 (3)J1645 0 (3)J1650 0 (3)J1652 0 (3)J1655 0 (3)J1670 0 (3)J1675 0 (3)J1700 0 (3)J1710 0 (3)J1720 0 (3)J1726 0 (3)J1729 0 (3)
HCPCS MUEJ1730 0 (3)J1740 0 (3)J1741 0 (3)J1742 0 (3)J1743 0 (3)J1744 0 (3)J1745 0 (3)J1750 0 (3)J1756 0 (3)J1786 0 (3)J1790 0 (3)J1800 0 (3)J1810 0 (3)J1815 0 (3)J1817 270 (3)J1826 0 (3)J1830 0 (3)J1833 0 (3)J1835 0 (3)J1840 0 (3)J1850 0 (3)J1885 0 (3)J1890 0 (3)J1930 0 (3)J1931 0 (3)J1940 0 (3)J1942 0 (3)J1945 0 (3)J1950 0 (3)J1953 0 (3)J1955 0 (3)J1956 0 (3)J1960 0 (3)J1980 0 (3)J1990 0 (3)J2001 0 (3)J2010 0 (3)J2020 0 (3)J2060 0 (3)J2150 0 (3)J2170 0 (3)J2175 0 (3)J2180 0 (3)J2182 0 (3)J2185 0 (3)J2210 0 (3)J2212 0 (3)J2248 0 (3)J2250 0 (3)J2260 252 (3)J2265 0 (3)J2270 320 (3)J2274 0 (3)J2278 999 (3)J2280 0 (3)J2300 0 (3)J2310 0 (3)J2315 0 (3)J2320 0 (3)J2323 0 (3)J2325 0 (3)J2326 0 (3)J2350 0 (3)J2353 0 (3)J2354 0 (3)
HCPCS MUEJ2355 0 (3)J2357 0 (3)J2358 0 (3)J2360 0 (3)J2370 0 (3)J2400 0 (3)J2405 0 (3)J2407 0 (3)J2410 0 (3)J2425 0 (3)J2426 0 (3)J2430 0 (3)J2440 0 (3)J2460 0 (3)J2469 0 (3)J2501 0 (3)J2502 0 (3)J2503 0 (3)J2504 0 (3)J2505 0 (3)J2507 0 (3)J2510 0 (3)J2513 0 (3)J2515 0 (3)J2540 0 (3)J2543 0 (3)J2545 3 (3)J2547 0 (3)J2550 0 (3)J2560 0 (3)J2562 0 (3)J2590 0 (3)J2597 0 (3)J2650 0 (3)J2670 0 (3)J2675 0 (3)J2680 0 (3)J2690 0 (3)J2700 0 (3)J2704 0 (3)J2710 0 (3)J2720 0 (3)J2724 0 (3)J2725 0 (3)J2730 0 (3)J2760 0 (3)J2765 0 (3)J2770 0 (3)J2778 0 (3)J2780 0 (3)J2783 0 (3)J2785 0 (3)J2786 0 (3)J2788 0 (3)J2790 0 (3)J2791 0 (3)J2792 0 (3)J2793 0 (3)J2794 0 (3)J2795 0 (3)J2796 0 (3)J2800 0 (3)J2805 0 (3)J2810 0 (3)J2820 0 (3)
HCPCS MUEJ2840 0 (3)J2850 0 (3)J2860 0 (3)J2910 0 (3)J2916 0 (3)J2920 25 (3)J2930 25 (3)J2940 0 (3)J2941 0 (3)J2950 0 (3)J2993 0 (3)J2995 0 (3)J2997 0 (3)J3000 0 (3)J3010 700 (3)J3030 0 (3)J3060 0 (3)J3070 0 (3)J3090 0 (3)J3095 0 (3)J3101 0 (3)J3105 0 (3)J3110 0 (3)J3121 0 (3)J3145 0 (3)J3230 0 (3)J3240 0 (3)J3243 0 (3)J3246 0 (3)J3250 0 (3)J3260 0 (3)J3262 0 (3)J3265 0 (3)J3280 0 (3)J3285 400 (3)J3300 0 (3)J3301 0 (3)J3302 0 (3)J3303 0 (3)J3305 0 (3)J3310 0 (3)J3315 0 (3)J3320 0 (3)J3350 0 (3)J3355 0 (3)J3357 0 (3)J3358 0 (3)J3360 0 (3)J3364 0 (3)J3365 0 (3)J3370 0 (3)J3380 0 (3)J3385 0 (3)J3396 0 (3)J3400 0 (3)J3410 0 (3)J3411 0 (3)J3415 0 (3)J3420 0 (3)J3430 0 (3)J3465 0 (3)J3470 0 (3)J3471 0 (3)J3472 0 (3)J3473 0 (3)
HCPCS MUEJ3475 0 (3)J3480 0 (3)J3485 0 (3)J3486 0 (3)J3489 0 (3)J3520 0 (3)J3530 0 (3)J3535 0 (3)J3570 0 (3)J7030 0 (3)J7040 0 (3)J7042 0 (3)J7050 0 (3)J7060 0 (3)J7070 0 (3)J7100 0 (3)J7110 0 (3)J7120 0 (3)J7121 0 (3)J7131 0 (3)J7340 56 (3)J7500 450 (3)J7501 8 (3)J7502 240 (3)J7503 3600 (3)J7504 0 (3)J7505 0 (3)J7507 1200 (3)J7508 9000 (3)J7509 360 (3)J7510 240 (3)J7511 0 (3)J7512 7000 (3)J7513 0 (3)J7515 600 (3)J7516 0 (3)J7517 480 (3)J7518 360 (3)J7520 600 (3)J7525 0 (3)J7527 960 (3)J7604 0 (3)J7605 186 (3)J7606 186 (3)J7607 0 (3)J7608 222 (3)J7609 0 (3)J7610 0 (3)J7611 1395 (3)J7612 900 (3)J7613 1395 (3)J7614 900 (3)J7615 0 (3)J7620 558 (3)J7622 0 (3)J7624 0 (3)J7626 186 (3)J7627 0 (3)J7628 0 (3)J7629 0 (3)J7631 744 (3)J7632 0 (3)J7633 0 (3)J7634 0 (3)J7635 0 (3)
HCPCS MUEJ7636 0 (3)J7637 0 (3)J7638 0 (3)J7639 234 (3)J7640 0 (3)J7641 0 (3)J7642 0 (3)J7643 0 (3)J7644 279 (3)J7645 0 (3)J7647 0 (3)J7648 0 (3)J7649 0 (3)J7650 0 (3)J7657 0 (3)J7658 0 (3)J7659 0 (3)J7660 0 (3)J7665 0 (3)J7667 0 (3)J7668 0 (3)J7669 0 (3)J7670 0 (3)J7674 0 (3)J7676 0 (3)J7680 0 (3)J7681 0 (3)J7682 112 (3)J7683 0 (3)J7684 0 (3)J7685 0 (3)J7686 28 (3)J7999 0 (3)J8499 0 (3)J8501 57 (3)J8515 0 (3)J8530 180 (3)J8540 216 (3)J8565 0 (3)J8610 12 (3)J8650 14 (3)J8655 1 (3)J8670 180 (3)J9000 20 (3)J9015 0 (3)J9017 0 (3)J9019 0 (3)J9020 0 (3)J9022 0 (3)J9023 0 (3)J9025 0 (3)J9027 0 (3)J9031 0 (3)J9032 0 (3)J9033 0 (3)J9034 0 (3)J9035 0 (3)J9040 4 (3)J9041 0 (3)J9042 0 (3)J9043 0 (3)J9045 0 (3)J9047 0 (3)J9050 0 (3)J9055 0 (3)
HCPCS MUEJ9060 0 (3)J9065 100 (3)J9070 0 (3)J9098 0 (3)J9100 60 (3)J9120 0 (3)J9130 0 (3)J9145 0 (3)J9150 0 (3)J9151 0 (3)J9155 0 (3)J9160 0 (3)J9165 0 (3)J9171 0 (3)J9175 0 (3)J9176 0 (3)J9178 0 (3)J9179 0 (3)J9181 11 (3)J9185 0 (3)J9190 20 (3)J9200 16 (3)J9201 0 (3)J9202 0 (3)J9203 0 (3)J9205 0 (3)J9206 0 (3)J9207 0 (3)J9208 0 (3)J9209 0 (3)J9211 0 (3)J9212 0 (3)J9213 0 (3)J9214 0 (3)J9215 0 (3)J9216 0 (3)J9217 0 (3)J9218 0 (3)J9219 0 (3)J9225 0 (3)J9226 0 (3)J9228 0 (3)J9230 0 (3)J9245 0 (3)J9250 0 (3)J9260 0 (3)J9261 0 (3)J9262 0 (3)J9263 0 (3)J9264 0 (3)J9266 0 (3)J9267 0 (3)J9268 0 (3)J9270 0 (3)J9271 0 (3)J9280 0 (3)J9285 0 (3)J9293 0 (3)J9295 0 (3)J9299 0 (3)J9301 0 (3)J9302 0 (3)J9303 0 (3)J9305 0 (3)J9306 0 (3)
HCPCS MUE
Medically Unlikely Edits (MUEs) 2019 HCPCS Level II
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J9307 0 (3)J9308 0 (3)J9315 0 (3)J9320 0 (3)J9325 0 (3)J9328 0 (3)J9330 0 (3)J9340 0 (3)J9351 0 (3)J9352 0 (3)J9354 0 (3)J9355 0 (3)J9357 0 (3)J9360 45 (3)J9370 4 (3)J9371 0 (3)J9390 0 (3)J9395 0 (3)J9400 0 (3)J9600 0 (3)J9999 0 (3)K0001 1 (2)K0002 1 (2)K0003 1 (2)K0004 1 (2)K0005 1 (2)K0006 1 (2)K0007 1 (2)K0008 1 (2)K0009 1 (2)K0010 0 (3)K0011 0 (3)K0012 0 (3)K0013 1 (2)K0014 0 (3)K0015 2 (2)K0017 2 (2)K0018 2 (2)K0019 2 (2)K0020 1 (2)K0037 2 (2)K0038 2 (3)K0039 2 (3)K0040 2 (2)K0041 2 (2)K0042 2 (2)K0043 2 (2)K0044 2 (2)K0045 2 (2)K0046 2 (2)K0047 2 (2)K0050 2 (2)K0051 2 (2)K0052 2 (2)K0053 2 (2)K0056 1 (2)K0065 2 (2)K0069 2 (2)K0070 2 (2)K0071 2 (2)K0072 2 (2)K0073 2 (2)K0077 2 (2)K0098 2 (3)K0105 1 (2)
HCPCS MUEK0195 1 (3)K0455 1 (2)K0462 1 (3)K0553 1 (2)K0554 1 (2)K0604 6 (3)K0605 4 (3)K0606 1 (2)K0607 1 (3)K0608 1 (3)K0609 1 (3)K0669 0 (3)K0672 4 (3)K0730 1 (3)K0733 2 (2)K0738 1 (2)K0740 0 (3)K0743 0 (3)K0800 1 (2)K0801 1 (2)K0802 1 (2)K0806 1 (2)K0807 1 (2)K0808 1 (2)K0812 1 (2)K0813 1 (2)K0814 1 (2)K0815 1 (2)K0816 1 (2)K0820 1 (2)K0821 1 (2)K0822 1 (2)K0823 1 (2)K0824 1 (2)K0825 1 (2)K0826 1 (2)K0827 1 (2)K0828 1 (2)K0829 1 (2)K0830 1 (2)K0831 1 (2)K0835 1 (2)K0836 1 (2)K0837 1 (2)K0838 1 (2)K0839 1 (2)K0840 1 (2)K0841 1 (2)K0842 1 (2)K0843 1 (2)K0848 1 (2)K0849 1 (2)K0850 1 (2)K0851 1 (2)K0852 1 (2)K0853 1 (2)K0854 1 (2)K0855 1 (2)K0856 1 (2)K0857 1 (2)K0858 1 (2)K0859 1 (2)K0860 1 (2)K0861 1 (2)K0862 1 (2)
HCPCS MUEK0863 1 (2)K0864 1 (2)K0868 1 (2)K0869 1 (2)K0870 1 (2)K0871 1 (2)K0877 1 (2)K0878 1 (2)K0879 1 (2)K0880 1 (2)K0884 1 (2)K0885 1 (2)K0886 1 (2)K0890 1 (2)K0891 1 (2)K0898 1 (2)K0899 0 (3)K0900 1 (3)L0112 1 (2)L0113 1 (2)L0120 1 (2)L0130 1 (2)L0140 1 (2)L0150 1 (2)L0160 1 (2)L0170 1 (2)L0172 1 (2)L0174 1 (2)L0180 1 (2)L0190 1 (2)L0200 1 (2)L0220 1 (3)L0450 1 (2)L0452 1 (2)L0454 1 (2)L0455 1 (2)L0456 1 (2)L0457 1 (2)L0458 1 (2)L0460 1 (2)L0462 1 (2)L0464 1 (2)L0466 1 (2)L0467 1 (2)L0468 1 (2)L0469 1 (2)L0470 1 (2)L0472 1 (2)L0480 1 (2)L0482 1 (2)L0484 1 (2)L0486 1 (2)L0488 1 (2)L0490 1 (2)L0491 1 (2)L0492 1 (2)L0621 1 (2)L0622 1 (2)L0623 1 (2)L0624 1 (2)L0625 1 (2)L0626 1 (2)L0627 1 (2)L0628 1 (2)L0629 1 (2)
HCPCS MUEL0630 1 (2)L0631 1 (2)L0632 1 (2)L0633 1 (2)L0634 1 (2)L0635 1 (2)L0636 1 (2)L0637 1 (2)L0638 1 (2)L0639 1 (2)L0640 1 (2)L0641 1 (2)L0642 1 (2)L0643 1 (2)L0648 1 (2)L0649 1 (2)L0650 1 (2)L0651 1 (2)L0700 1 (2)L0710 1 (2)L0810 1 (2)L0820 1 (2)L0830 1 (2)L0859 1 (2)L0861 1 (2)L0970 1 (2)L0972 1 (2)L0974 1 (2)L0976 1 (2)L0978 2 (3)L0980 1 (2)L0982 1 (3)L0984 0 (3)L1000 1 (2)L1001 1 (2)L1005 1 (2)L1010 2 (2)L1020 2 (3)L1025 1 (3)L1030 1 (3)L1040 1 (3)L1050 1 (3)L1060 1 (3)L1070 2 (2)L1080 2 (2)L1085 1 (2)L1090 1 (3)L1100 2 (2)L1110 2 (2)L1120 3 (3)L1200 1 (2)L1210 2 (3)L1220 1 (3)L1230 1 (2)L1240 1 (3)L1250 2 (3)L1260 1 (3)L1270 3 (3)L1280 2 (3)L1290 2 (3)L1300 1 (2)L1310 1 (2)L1499 1 (3)L1600 1 (2)L1610 1 (2)
HCPCS MUEL1620 1 (2)L1630 1 (2)L1640 1 (2)L1650 1 (2)L1652 1 (2)L1660 1 (2)L1680 1 (2)L1685 1 (2)L1686 1 (3)L1690 1 (2)L1700 1 (2)L1710 1 (2)L1720 2 (2)L1730 1 (2)L1755 2 (2)L1810 2 (2)L1812 2 (2)L1820 2 (2)L1830 2 (2)L1831 2 (2)L1832 2 (2)L1833 2 (2)L1834 2 (2)L1836 2 (2)L1840 2 (2)L1843 2 (2)L1844 2 (2)L1845 2 (2)L1846 2 (2)L1847 2 (2)L1848 2 (2)L1850 2 (2)L1851 2 (2)L1852 2 (2)L1860 2 (2)L1900 2 (2)L1902 2 (2)L1904 2 (2)L1906 2 (2)L1907 2 (2)L1910 2 (2)L1920 2 (2)L1930 2 (2)L1932 2 (2)L1940 2 (2)L1945 2 (2)L1950 2 (2)L1951 2 (2)L1960 2 (2)L1970 2 (2)L1971 2 (2)L1980 2 (2)L1990 2 (2)L2000 2 (2)L2005 2 (2)L2010 2 (2)L2020 2 (2)L2030 2 (2)L2034 2 (2)L2035 2 (2)L2036 2 (2)L2037 2 (2)L2038 2 (2)L2040 1 (2)L2050 1 (2)
HCPCS MUEL2060 1 (2)L2070 1 (2)L2080 1 (2)L2090 1 (2)L2106 2 (2)L2108 2 (2)L2112 2 (2)L2114 2 (2)L2116 2 (2)L2126 2 (2)L2128 2 (2)L2132 2 (2)L2134 2 (2)L2136 2 (2)L2180 2 (2)L2182 4 (2)L2184 4 (2)L2186 4 (2)L2188 2 (2)L2190 2 (2)L2192 2 (2)L2200 4 (2)L2210 4 (2)L2220 4 (2)L2230 2 (2)L2232 2 (2)L2240 2 (2)L2250 2 (2)L2260 2 (2)L2265 2 (2)L2270 2 (3)L2275 2 (3)L2280 2 (2)L2300 1 (2)L2310 1 (2)L2320 2 (3)L2330 2 (3)L2335 2 (2)L2340 2 (2)L2350 2 (2)L2360 2 (2)L2370 2 (2)L2375 2 (2)L2380 2 (3)L2385 4 (2)L2387 4 (2)L2390 4 (2)L2395 4 (2)L2397 4 (3)L2405 4 (2)L2415 4 (2)L2425 4 (2)L2430 4 (2)L2492 4 (2)L2500 2 (2)L2510 2 (2)L2520 2 (2)L2525 2 (2)L2526 2 (2)L2530 2 (2)L2540 2 (2)L2550 2 (2)L2570 2 (2)L2580 2 (2)L2600 2 (2)
HCPCS MUEL2610 2 (2)L2620 2 (2)L2622 2 (2)L2624 2 (2)L2627 1 (3)L2628 1 (3)L2630 1 (2)L2640 1 (2)L2650 2 (3)L2660 1 (3)L2670 2 (3)L2680 2 (3)L2750 8 (3)L2755 8 (3)L2760 8 (2)L2768 4 (2)L2780 8 (3)L2785 4 (2)L2795 2 (2)L2800 2 (2)L2810 4 (2)L2820 2 (3)L2830 2 (3)L2840 0 (3)L2850 0 (3)L2861 0 (3)L3000 2 (3)L3001 2 (3)L3002 2 (3)L3003 2 (3)L3010 2 (3)L3020 2 (3)L3030 2 (3)L3031 2 (3)L3040 2 (3)L3050 2 (3)L3060 2 (3)L3070 2 (3)L3080 2 (3)L3090 2 (3)L3100 2 (2)L3140 1 (2)L3150 1 (2)L3160 2 (2)L3170 2 (2)L3201 1 (3)L3202 1 (3)L3203 1 (3)L3204 1 (3)L3206 1 (3)L3207 1 (3)L3208 1 (3)L3209 1 (3)L3211 1 (3)L3212 1 (3)L3213 1 (3)L3214 1 (3)L3215 0 (3)L3216 2 (2)L3217 2 (2)L3219 0 (3)L3221 2 (2)L3222 2 (2)L3224 2 (2)L3225 2 (2)
HCPCS MUEL3230 2 (2)L3250 2 (2)L3251 2 (2)L3252 2 (2)L3253 2 (2)L3254 1 (3)L3255 1 (3)L3257 1 (3)L3260 0 (3)L3265 0 (3)L3300 4 (3)L3310 4 (3)L3330 2 (2)L3332 2 (2)L3334 4 (3)L3340 2 (2)L3350 2 (2)L3360 2 (2)L3370 2 (2)L3380 2 (2)L3390 2 (2)L3400 2 (2)L3410 2 (2)L3420 2 (2)L3430 2 (2)L3440 2 (2)L3450 2 (2)L3455 2 (2)L3460 2 (2)L3465 2 (2)L3470 2 (2)L3480 2 (2)L3485 2 (2)L3500 2 (2)L3510 2 (2)L3520 2 (2)L3530 2 (2)L3540 2 (2)L3550 2 (2)L3560 2 (2)L3570 2 (2)L3580 2 (2)L3590 2 (2)L3595 2 (2)L3600 2 (2)L3610 2 (2)L3620 2 (2)L3630 2 (2)L3640 1 (2)L3650 1 (2)L3660 1 (2)L3670 1 (3)L3671 1 (3)L3674 1 (3)L3675 1 (2)L3677 1 (2)L3678 1 (2)L3702 2 (2)L3710 2 (2)L3720 2 (2)L3730 2 (2)L3740 2 (2)L3760 2 (2)L3761 2 (2)L3762 2 (2)
HCPCS MUE
2019 HCPCS Level II Medically Unlikely Edits (MUEs)
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L3763 2 (2)L3764 2 (2)L3765 2 (2)L3766 2 (2)L3806 2 (2)L3807 2 (2)L3808 2 (2)L3809 2 (2)L3891 0 (3)L3900 2 (2)L3901 2 (2)L3904 2 (2)L3905 2 (2)L3906 2 (2)L3908 2 (2)L3912 2 (3)L3913 2 (2)L3915 2 (2)L3916 2 (3)L3917 2 (2)L3918 2 (2)L3919 2 (2)L3921 2 (2)L3923 2 (2)L3924 2 (2)L3925 4 (3)L3927 4 (3)L3929 2 (2)L3930 2 (2)L3931 2 (2)L3933 3 (3)L3935 3 (3)L3956 4 (3)L3960 1 (3)L3961 1 (3)L3962 1 (3)L3967 1 (3)L3971 1 (3)L3973 1 (3)L3975 1 (3)L3976 1 (3)L3977 1 (3)L3978 1 (3)L3980 2 (2)L3981 2 (2)L3982 2 (2)L3984 2 (2)L4000 1 (2)L4002 8 (3)L4010 2 (2)L4020 2 (2)L4030 2 (2)L4040 2 (2)L4045 2 (2)L4050 2 (2)L4055 2 (2)L4060 2 (2)L4070 2 (3)L4080 2 (2)L4090 4 (2)L4100 2 (2)L4110 4 (2)L4130 2 (2)L4205 8 (3)L4210 4 (3)
HCPCS MUEL4350 2 (2)L4360 2 (2)L4361 2 (2)L4370 2 (2)L4386 2 (2)L4387 2 (2)L4392 2 (3)L4394 2 (3)L4396 2 (2)L4397 2 (2)L4398 2 (2)L4631 2 (2)L5000 2 (3)L5010 2 (2)L5020 2 (2)L5050 2 (2)L5060 2 (2)L5100 2 (2)L5105 2 (2)L5150 2 (2)L5160 2 (2)L5200 2 (2)L5210 2 (2)L5220 2 (2)L5230 2 (2)L5250 2 (2)L5270 2 (2)L5280 2 (2)L5301 2 (2)L5312 2 (2)L5321 2 (2)L5331 2 (2)L5341 2 (2)L5400 2 (2)L5410 2 (2)L5420 2 (2)L5430 2 (2)L5450 2 (2)L5460 2 (2)L5500 2 (2)L5505 2 (2)L5510 2 (2)L5520 2 (2)L5530 2 (2)L5535 2 (2)L5540 2 (2)L5560 2 (2)L5570 2 (2)L5580 2 (2)L5585 2 (2)L5590 2 (2)L5595 2 (2)L5600 2 (2)L5610 2 (2)L5611 2 (2)L5613 2 (2)L5614 2 (2)L5616 2 (2)L5617 2 (3)L5618 4 (3)L5620 4 (3)L5622 4 (3)L5624 4 (3)L5626 4 (3)L5628 2 (3)
HCPCS MUEL5629 2 (2)L5630 2 (2)L5631 2 (2)L5632 2 (2)L5634 2 (2)L5636 2 (2)L5637 2 (2)L5638 2 (2)L5639 2 (2)L5640 2 (2)L5642 2 (2)L5643 2 (2)L5644 2 (2)L5645 2 (2)L5646 2 (2)L5647 2 (2)L5648 2 (2)L5649 2 (2)L5650 2 (2)L5651 2 (2)L5652 2 (2)L5653 2 (2)L5654 2 (3)L5655 2 (3)L5656 2 (3)L5658 2 (3)L5661 2 (3)L5665 2 (3)L5666 2 (2)L5668 2 (3)L5670 2 (2)L5671 2 (2)L5672 2 (2)L5673 4 (3)L5676 2 (2)L5677 2 (2)L5678 2 (2)L5679 4 (3)L5680 2 (2)L5681 2 (2)L5682 2 (2)L5683 2 (2)L5684 2 (3)L5685 4 (3)L5686 2 (2)L5688 2 (3)L5690 2 (3)L5692 2 (2)L5694 2 (2)L5695 2 (3)L5696 2 (2)L5697 2 (2)L5698 2 (2)L5699 2 (3)L5700 2 (2)L5701 2 (2)L5702 2 (2)L5703 2 (2)L5704 2 (2)L5705 2 (2)L5706 2 (2)L5707 2 (2)L5710 2 (2)L5711 2 (2)L5712 2 (2)
HCPCS MUEL5714 2 (2)L5716 2 (2)L5718 2 (2)L5722 2 (2)L5724 2 (2)L5726 2 (2)L5728 2 (2)L5780 2 (2)L5781 2 (2)L5782 2 (2)L5785 2 (2)L5790 2 (2)L5795 2 (2)L5810 2 (2)L5811 2 (2)L5812 2 (2)L5814 2 (2)L5816 2 (2)L5818 2 (2)L5822 2 (2)L5824 2 (2)L5826 2 (2)L5828 2 (2)L5830 2 (2)L5840 2 (2)L5845 2 (2)L5848 2 (2)L5850 2 (2)L5855 2 (2)L5856 2 (2)L5857 2 (2)L5858 2 (2)L5859 2 (2)L5910 2 (2)L5920 2 (2)L5925 2 (3)L5930 2 (2)L5940 2 (2)L5950 2 (2)L5960 2 (2)L5961 1 (3)L5962 2 (2)L5964 2 (2)L5966 2 (2)L5968 2 (2)L5969 0 (3)L5970 2 (2)L5971 2 (2)L5972 2 (2)L5973 2 (2)L5974 2 (2)L5975 2 (2)L5976 2 (2)L5978 2 (2)L5979 2 (2)L5980 2 (2)L5981 2 (2)L5982 2 (2)L5984 2 (2)L5985 2 (2)L5986 2 (2)L5987 2 (2)L5988 2 (2)L5990 2 (2)L6000 2 (2)
HCPCS MUEL6010 2 (2)L6020 2 (2)L6026 2 (2)L6050 2 (2)L6055 2 (2)L6100 2 (2)L6110 2 (2)L6120 2 (2)L6130 2 (2)L6200 2 (2)L6205 2 (2)L6250 2 (2)L6300 2 (2)L6310 2 (2)L6320 2 (2)L6350 2 (2)L6360 2 (2)L6370 2 (2)L6380 2 (2)L6382 2 (2)L6384 2 (2)L6386 2 (2)L6388 2 (2)L6400 2 (2)L6450 2 (2)L6500 2 (2)L6550 2 (2)L6570 2 (2)L6580 2 (2)L6582 2 (2)L6584 2 (2)L6586 2 (2)L6588 2 (2)L6590 2 (2)L6600 2 (2)L6605 2 (2)L6610 2 (2)L6611 2 (3)L6615 2 (2)L6616 2 (2)L6620 2 (2)L6621 2 (2)L6623 2 (2)L6624 2 (2)L6625 2 (2)L6628 2 (2)L6629 2 (2)L6630 2 (2)L6632 4 (3)L6635 2 (2)L6637 2 (2)L6638 2 (2)L6640 2 (2)L6641 2 (3)L6642 2 (3)L6645 2 (2)L6646 2 (2)L6647 2 (2)L6648 2 (2)L6650 2 (2)L6655 4 (3)L6660 4 (3)L6665 4 (3)L6670 2 (2)L6672 2 (2)
HCPCS MUEL6675 2 (2)L6676 2 (2)L6677 2 (2)L6680 4 (3)L6682 4 (3)L6684 4 (3)L6686 2 (2)L6687 2 (2)L6688 2 (2)L6689 2 (2)L6690 2 (2)L6691 2 (3)L6692 2 (3)L6693 2 (2)L6694 2 (3)L6695 2 (3)L6696 2 (2)L6697 2 (2)L6698 2 (2)L6703 2 (2)L6704 2 (2)L6706 2 (2)L6707 2 (2)L6708 2 (2)L6709 2 (2)L6711 2 (2)L6712 2 (2)L6713 2 (2)L6714 2 (2)L6715 5 (3)L6721 2 (2)L6722 2 (2)L6805 2 (2)L6810 2 (3)L6880 2 (2)L6881 2 (2)L6882 2 (2)L6883 2 (2)L6884 2 (2)L6885 2 (2)L6890 2 (3)L6895 2 (3)L6900 2 (2)L6905 2 (2)L6910 2 (2)L6915 2 (2)L6920 2 (2)L6925 2 (2)L6930 2 (2)L6935 2 (2)L6940 2 (2)L6945 2 (2)L6950 2 (2)L6955 2 (2)L6960 2 (2)L6965 2 (2)L6970 2 (2)L6975 2 (2)L7007 2 (2)L7008 2 (2)L7009 2 (2)L7040 2 (2)L7045 2 (2)L7170 2 (2)L7180 2 (2)
HCPCS MUEL7181 2 (2)L7185 2 (2)L7186 2 (2)L7190 2 (2)L7191 2 (2)L7259 2 (2)L7360 1 (3)L7362 1 (2)L7364 1 (3)L7366 1 (2)L7367 2 (3)L7368 1 (2)L7400 2 (2)L7401 2 (2)L7402 2 (2)L7403 2 (2)L7404 2 (2)L7405 2 (2)L7510 4 (3)L7520 12 (3)L7600 0 (3)L7700 2 (1)L7900 0 (3)L7902 0 (3)L8000 6 (3)L8001 4 (3)L8002 4 (3)L8010 0 (3)L8015 4 (3)L8020 4 (3)L8030 2 (3)L8031 2 (3)L8032 2 (2)L8035 2 (3)L8039 2 (3)L8040 1 (2)L8041 1 (2)L8042 2 (2)L8043 1 (2)L8044 1 (2)L8045 2 (2)L8046 1 (3)L8047 1 (2)L8048 1 (3)L8049 6 (3)L8300 1 (3)L8310 1 (3)L8320 2 (3)L8330 2 (3)L8400 12 (3)L8410 12 (3)L8415 6 (3)L8417 12 (3)L8420 24 (3)L8430 24 (3)L8435 12 (3)L8440 4 (3)L8460 4 (3)L8465 4 (3)L8470 24 (3)L8480 24 (3)L8485 12 (3)L8500 1 (2)L8501 2 (3)L8507 3 (3)
HCPCS MUEL8509 0 (3)L8510 1 (2)L8511 1 (3)L8512 9 (3)L8513 6 (3)L8514 1 (3)L8515 1 (3)L8600 0 (3)L8609 0 (3)L8610 0 (3)L8612 0 (3)L8613 0 (3)L8614 0 (3)L8615 0 (3)L8616 0 (3)L8617 0 (3)L8618 0 (3)L8619 0 (3)L8621 0 (3)L8622 0 (3)L8623 0 (3)L8624 0 (3)L8630 0 (3)L8631 0 (3)L8641 0 (3)L8642 0 (3)L8658 0 (3)L8659 0 (3)L8670 0 (3)L8680 0 (3)L8681 0 (3)L8682 0 (3)L8683 0 (3)L8684 0 (3)L8685 0 (3)L8686 0 (3)L8687 0 (3)L8688 0 (3)L8689 0 (3)L8690 0 (3)L8691 0 (3)L8692 0 (3)L8693 0 (3)L8695 0 (3)L9900 0 (3)Q0035 0 (3)Q0091 0 (3)Q0092 0 (3)Q0111 0 (3)Q0112 0 (3)Q0113 0 (3)Q0114 0 (3)Q0115 0 (3)Q0144 0 (3)Q0161 66 (3)Q0162 40 (3)Q0163 13 (3)Q0164 18 (3)Q0166 2 (3)Q0167 108 (3)Q0169 26 (3)Q0173 11 (3)Q0174 0 (3)Q0175 14 (3)Q0177 36 (3)
HCPCS MUE
Medically Unlikely Edits (MUEs) 2019 HCPCS Level II
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Q0180 1 (3)Q0478 0 (3)Q0479 0 (3)Q0480 0 (3)Q0481 0 (3)Q0482 0 (3)Q0483 0 (3)Q0484 0 (3)Q0485 0 (3)Q0486 0 (3)Q0487 0 (3)Q0488 0 (3)Q0489 0 (3)Q0490 0 (3)Q0491 0 (3)Q0492 0 (3)Q0493 0 (3)Q0494 0 (3)Q0495 0 (3)Q0496 0 (3)Q0497 0 (3)Q0498 0 (3)Q0499 0 (3)Q0500 0 (3)Q0501 0 (3)Q0502 0 (3)Q0503 0 (3)
HCPCS MUEQ0504 0 (3)Q0510 1 (2)Q0511 1 (2)Q0512 4 (3)Q0513 1 (2)Q0514 1 (2)Q1004 0 (3)Q1005 0 (3)Q2049 0 (3)Q2050 0 (3)Q2052 1 (2)Q4001 0 (3)Q4002 0 (3)Q4003 0 (3)Q4004 0 (3)Q4005 0 (3)Q4006 0 (3)Q4007 0 (3)Q4008 0 (3)Q4009 0 (3)Q4010 0 (3)Q4011 0 (3)Q4012 0 (3)Q4013 0 (3)Q4014 0 (3)Q4015 0 (3)Q4016 0 (3)
HCPCS MUEQ4017 0 (3)Q4018 0 (3)Q4019 0 (3)Q4020 0 (3)Q4021 0 (3)Q4022 0 (3)Q4023 0 (3)Q4024 0 (3)Q4025 0 (3)Q4026 0 (3)Q4027 0 (3)Q4028 0 (3)Q4029 0 (3)Q4030 0 (3)Q4031 0 (3)Q4032 0 (3)Q4033 0 (3)Q4034 0 (3)Q4035 0 (3)Q4036 0 (3)Q4037 0 (3)Q4038 0 (3)Q4039 0 (3)Q4040 0 (3)Q4041 0 (3)Q4042 0 (3)Q4043 0 (3)
HCPCS MUEQ4044 0 (3)Q4045 0 (3)Q4046 0 (3)Q4047 0 (3)Q4048 0 (3)Q4049 0 (3)Q4074 279 (3)Q5101 0 (3)Q5103 0 (3)Q5104 0 (3)V2020 1 (3)V2025 0 (3)V2100 2 (3)V2101 2 (3)V2102 2 (3)V2103 2 (3)V2104 2 (3)V2105 2 (3)V2106 2 (3)V2107 2 (3)V2108 2 (3)V2109 2 (3)V2110 2 (3)V2111 2 (3)V2112 2 (3)V2113 2 (3)V2114 2 (3)
HCPCS MUEV2115 2 (3)V2118 2 (3)V2121 2 (3)V2199 2 (3)V2200 2 (3)V2201 2 (3)V2202 2 (3)V2203 2 (3)V2204 2 (3)V2205 2 (3)V2206 2 (3)V2207 2 (3)V2208 2 (3)V2209 2 (3)V2210 2 (3)V2211 2 (3)V2212 2 (3)V2213 2 (3)V2214 2 (3)V2215 2 (3)V2218 2 (3)V2219 2 (3)V2220 2 (3)V2221 2 (3)V2299 2 (3)V2300 2 (3)V2301 2 (3)
HCPCS MUEV2302 2 (3)V2303 2 (3)V2304 2 (3)V2305 2 (3)V2306 2 (3)V2307 2 (3)V2308 2 (3)V2309 2 (3)V2310 2 (3)V2311 2 (3)V2312 2 (3)V2313 2 (3)V2314 2 (3)V2315 2 (3)V2318 2 (3)V2319 2 (3)V2320 2 (3)V2321 2 (3)V2399 2 (3)V2410 2 (3)V2430 2 (3)V2499 2 (3)V2500 2 (3)V2501 2 (3)V2502 2 (3)V2503 2 (3)V2510 2 (3)
HCPCS MUEV2511 2 (3)V2512 2 (3)V2513 2 (3)V2520 2 (3)V2521 2 (3)V2522 2 (3)V2523 2 (3)V2530 2 (3)V2531 2 (3)V2599 2 (3)V2600 0 (2)V2610 0 (2)V2615 0 (2)V2623 2 (2)V2624 2 (2)V2625 2 (2)V2626 2 (2)V2627 2 (2)V2628 2 (3)V2629 2 (2)V2630 0 (3)V2631 0 (3)V2632 0 (3)v2700 2 (3)V2702 0 (3)V2710 2 (3)V2715 4 (3)
HCPCS MUEV2718 2 (3)V2730 2 (3)V2744 2 (3)V2745 2 (3)V2750 2 (3)V2755 2 (3)V2756 0 (3)V2760 0 (3)V2761 0 (2)V2762 0 (3)V2770 2 (3)V2780 2 (3)V2781 0 (2)V2782 2 (3)V2783 2 (3)V2784 2 (3)V2785 0 (3)V2786 0 (3)V2790 0 (3)V2797 0 (3)V5008 0 (3)V5010 0 (3)V5011 0 (3)V5274 0 (3)V5336 0 (3)
HCPCS MUE