MedicaidAdministrativeMedium impact
Attention Practitioners, Ambulatory Surgical Centers, Outpatient Hospitals and Durable Medical Equipment Providers: Reminder Regarding National Correct Coding Initiative (NCCI) Medically Unlikely Edits (MUEs)
Nevada Medicaid·NV·Billing & Coding
We identified it
Jun 21, 2026
Summary
Nevada Medicaid is reminding providers about National Correct Coding Initiative (NCCI) Medically Unlikely Edits (MUEs) that automatically deny claims when units of service exceed maximum allowable limits for the same patient on the same date. Claims exceeding MUE limits are denied entirely with specific error codes 4180, 4181, or 4182.
Action Required
Immediately: Billing team should review current claim submission practices to ensure units of service do not exceed MUE limits for HCPCS/CPT codes. Monitor for denial codes 4180 (Professional), 4181 (DME), and 4182 (Outpatient) and review MUE edit files at cms.gov/medicare/coding-billing/ncci-medicaid before resubmitting claims.