Medicare Claims Processing Manual (Pub. 100-04), Ch. 4 § 40.2
Outpatient Prospective Payment System (OPPS) OCE (Prior to
40.2 - Outpatient Prospective Payment System (OPPS) OCE (Prior to
July 1, 2007)
(Rev. 1107, Issued: 11-09-06, Effective: 07-01-07, Implementation: 07-02-07)
The OPPS OCE performs the following two major functions:
• Edit claims data to identify errors and return a series of edit flags; and
• Assign an ambulatory payment classification (APC) number for each service
covered under OPPS and return information to be used as input to the Pricer
program.
Effective January 5, 2003, Medicare contractors will be receiving subsequent
quarterly updates to these Outpatient Code Editor Specifications through a Recurring
Update Notification.