AHA Coding Clinic® for HCPCS - 2003 Issue 3; FOR your INFORMATION

Outpatient code editor (OCE) edit 15 reactivated

Charles CatalineSenior Director, Health PolicyThe Ohio Hospital Association The Centers for Medicare and Medicaid Services (CMS) has reactivated edit 15 (Service Unit Out of Range) on the outpatient code editor (OCE) for claims with dates of service on or after April 1, 2003. The OCE software—which includes national Correct Coding Initiative edits—screens Medicare claims for coding conflicts and inaccuracies, and it identifies potential problems with a series of “edit” reasons. CMS discontinued the use of OCE edit 15 last year after the software suspended a large number of Medicare claims, causing many to question the validity...

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