General Question for the Week of May 6, 2024

Question:

How does the OCE help in processing hospital claims related to Ambulatory Payment Classifications (APCs)?

Answer:

In your facility, the modified subset of the NCCI may be referred to as the OCE file. The outpatient code editor (OCE) is utilized for processing of hospital claims to group APCs and determine payment for OPPS services. Note that the OCE does not include NCCI edits for anesthesiology, evaluation, and management (E/M), mental health, certain injections, and wound closure by adhesive or computer-aided detection devices.

This question was answered in our Coding Essentials for RT/Pulmonary Function. For more hot topics relating to respiratory services, please visit our store or call us at 1.800.252.1578, ext. 2.

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