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Reference table

Medically Unlikely Edits

CMS Medically Unlikely Edits, practitioner services, 2026 Q2

Signed off v1
Read by mue_ceiling. Those nodes reach this table through table_lookup on code. A key that is not in the table is a no_match — the lookup fails closed on that node and the walk continues. It is not on_field_missing, which means something different: that the claim did not carry the field.

mue

1 of 15 rows matching “J9355”
codeceilingadjudication indicatorrationale
J9355 240 3 — date of service edit, clinical Derived from the maximum labelled dose over body surface area

Versions

Signed-off wins, else the highest. 1 on disk.

v1 · mue.v1.yaml 15 rows · CMS Medically Unlikely Edits, practitioner services, 2026 Q2 Active signed 2026-04-01