PI MUE Limits

Nature of Issue: Incorrect CMS Limit Denials for DME Services

Date Identified: 1/1/2023 to Current

Dates of Service Impacted: 1/1/2023 to Current

Product Line Impacted: MMP and Medicaid

Summary of Issue: Limit denials are in place when Michigan CHAMPS has no rule but CMS has a rule. Meridian is correcting edits to prevent CHAMPS Medicaid being overriden when CHAMPS states no limit when CMS has limit rule in place.

New Claim Submission Issue Resolution Date: TBD

Prior Claim Correction Issue Resolution Date: TBD

Any action required by the provider if applicable: Escalate any denials to your Provider Representative for overturn and review.