2075958
| Pregunta | Respuesta |
| What does NCCI stand for? | National Correct Coding Initiative |
| What does OCE stand for? | The Outpatient Code Editor |
| What is NCCI? | NCCI was developed by CMS to promote correct coding of healthcare services and prevention for inappropriate Medicare payment services |
| What is OCE? | OCE is used to process Outpatient Prospective Payment System (OPPS) claims |
| What does NCCI control? | NCCI controls improper payments on Medicare B part claims |
| What does NCCI edit? | Automated edits are triggered on claims submitted by providers who bill for more than one service for the same beneficiary on the same date of services |
| Purpose for NCCI? | NCCI edits, prevent improper payments when incorrect code combinations are reported, codes always consist of HCPCS and arranged in column one and two table coding edit file |
| What does the coding edit file table consist of? | It contains two types of code pair edits, one type contains a component service and the other is an integral part of the comprehensive service |
| What did CMS developed it's coding policies based on? | American Medical Association CPT's manual, national and local policies and edits, coding guidelines developed by national societies, analysis of medical and surgical practices and review of current coding practices |
| What are MUEs? | Medically Unlikely edits developed by CMS to reduce the paid claims error rate for part B claims |
| Do all HCPCS/CPT codes have an MUE? | No |
| How many edits does OCE have? | Over 50 OCE edits, which determine whether a specific code is payable under the hospital OPPS |
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