General Question for the Week of October 2, 2017

General Compliance Question of the Week

Question:

What’s the difference between the Outpatient Code Editor (OCE) edits and the National Correct Coding Initiative (NCCI) procedure to procedure (PTP) edits?

Answer:

The Outpatient Code Editor (OCE) is utilized to edit outpatient prospective payment system hospital claims processed through the Fiscal Intermediary Shared System (FISS). It contains more than 50 types of edits. NCCI PTP edits are one type of edit incorporated into OCE. The NCCI PTP edits incorporated into OCE are a subset of NCCI PTP edits utilized to adjudicate physician/practitioner claims through the Multi-Carrier System (MCS).

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.