What is the purpose of the Medicare Code Editor (MCE)?

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The Medicare Code Editor (MCE) plays a crucial role in ensuring the accuracy of health care claims submitted to Medicare. Its primary function is to identify and correct errors related to coding before the claims are processed. This includes verifying that diagnosis and procedure codes are appropriate and conform to Medicare's guidelines for billing.

By correcting incorrect billing data, the MCE helps minimize the risk of claim denials and rejections, leading to a more efficient revenue cycle management process. Ensuring that the claims are accurately coded is essential for proper reimbursement and compliance with Medicare regulations. This function directly supports health care providers in their efforts to secure timely payment for services rendered, thereby enhancing the financial sustainability of healthcare organizations.

Other functions mentioned in the options, such as processing patient eligibility or auditing providers, while important, do not encapsulate the primary purpose of the MCE. The focus here is on the editing aspect related to billing accuracy, which aligns with the correct answer.

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