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Outpatient Code Editor (OCE)

OCE Resources and Training

The Outpatient Code Editor (OCE) course was created by the Centers for Medicare & Medicaid Services (CMS). The course is useful for physicians, healthcare professionals, and medical administrative staff, to understand the OCE utilized under the Outpatient Prospective Payment System (OPPS) and other payment systems. This course addresses the OCE in the Fiscal Intermediary Standard (or Shared) System (FISS) and covers the following information.

  • Lesson One: Background Information, explores the background information of the Outpatient Code Editor (OCE) software program.
  • Lesson Two: Edit Types, explains types of edits in the Outpatient Prospective Payment System (OPPS) Outpatient Code Editor (OCE).
  • Lesson Three: Payment Information, explains payment information included in the Ambulatory Payment Classification (APC) Return Buffer.
  • Lesson Four: Special Conditions, describes special conditions applying to the Outpatient Code Editor (OCE) under Outpatient Prospective Payment System (OPPS).
  • Lesson Five: Correct Coding Initiative (CCI) Edits, explains Correct Coding Initiative (CCI) edits.
  • Lesson Six: Direct Data Entry (DDE), reviews the Outpatient Prospective Payment System (OPPS) Outpatient Code Editor (OCE) in the Fiscal Intermediary Standard (or Shared) System (FISS) via Direct Data Entry (DDE).
  • Lesson Seven: Resources, gives the resources available containing Outpatient Code Editor (OCE) information.

To access this web-based training course scroll to the bottom of the page and select the OCE WBT under the Related Links "Inside" CMS.


Downloads
JOB AIDS

Job Aid A FISS OCE Map [PDF, 154KB]

Job Aid B FISS Screens [PDF, 227KB]

OTHER DOWNLOADS

Appendix E(a) [OPPS flag =1] Logic for Assigning Payment Method Flag Values to a Line Item [PDF 44KB]

Appendix E(b) [OPPS flag = 2] Logic for Assigning Non-OPPS Hospital Payment Method Flag Values [PDF 22KB]

Appendix F(a) OCE Edits Applied by Bill Type (OPPS flag =1) [PDF 70KB]

Appendix F(b) OCE Edits Applied by Non-OPPS Hospital Bill Type (OPPS flag = 2) [PDF 72KB]

Description of edits/claim reasons Table [PDF 58KB]

Related Links Inside CMS

OCE WBT
Related Links Outside CMSExternal Linking Policy

There are no Related Links Outside CMS

 

Page Last Modified: 09/08/2008 9:38:30 AM
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