Course Code: REL-RCC-OPPS-C07
Hours: 0.5
Type: Online Course
Content Expiration Date: 12/31/2028
Learning Objectives:
Recall the function of the OCE edits.
Identify which OCE edits include the PTP edits.
Recognize how the MUEs work.
Locate Add-on edits.
Understand the distinctions among OCE edits, NCCI edits, PTP edits, and MUEs.
Outline:
Section 1: Introduction
About This Course
Learning Objectives
Section 2: Integrated Code Editor
Integrated Outpatient Code Editor Background
Integrated Outpatient Code Editor Software
Section 3: OCE Edits
Current OCE Edits
Current OCE Dispositions
Review
Sample RTP Edits
OCE Edit 17 Associated with the Bilateral Modifier
OCE Edit 74 Associated with the Bilateral Modifier
OCE Edit 21
OCE Edits Associated with Observation Services
Review
Section 4: PTP Edits
OCE Edits and NCCI Edits
Procedure to Procedure (PTP) Edits
Allowable Modifier Designation
Non-modifiable NCCI Edits: OCE Edit 20
Modifiable NCCI Edits: OCE Edit 40
Review
NCCI Coding Policy Manual for Medicare Services
Section 5: Medically Unlikely Edits
Medically Unlikely Edits, Part 1
Medically Unlikely Edits, Part 2
Adjudication of Medically Unlikely Edits
Examples of Medically Unlikely Edits
Examples of Laboratory Medically Unlikely Edits
Review
Add-on Code Edits
Section 6: Conclusion
Course Summary
Course Contributor(s)
References
Glossary
Reviewer: Brandi D. Burgett, CCS, CPC
Brandi has over twenty-five years of medical billing and coding experience. Her areas of expertise include beginning-to-end revenue cycle operations, hands-on coding for multiple outpatient specialties, and medical record auditing. Prior to medical coding, Brandi was a Team Lead for a large team of pediatric specialty providers in Virginia.
Target Audience:
The target audience for this course is: Healthcare Billing and Coding; in the following settings: Hospitals: Acute.
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To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Course Delivery Method and Format
Asynchronous Distance Learning with interactivity which includes quizzes with questions/answers, and posttests.