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The Clinical Classifications Software Refined (CCSR) for ICD-10-CM diagnoses aggregates over 70,000 ICD-10-CM diagnosis codes into a manageable number of clinically meaningful cate...
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The 'integrated' Outpatient Code Editor (I/OCE) program processes claims for all outpatient institutional providers including hospitals that are subject to the Outpatient Prospecti...
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The 'integrated' Outpatient Code Editor (I/OCE) program processes claims for all outpatient institutional providers including hospitals that are subject to the Outpatient Prospecti...
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The Claim will be identified as 'OPPS' or 'Non-OPPS'. Prior to OPPS, the software focused solely on editing claims without specifying any action to take when an edit occurred. It a...
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This data package contains the Diagnosis Related Groups (DRGs) patient classification system that provides a means of relating the type of patients a hospital treats to the costs i...
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This data package contains the Medically Unlikely Edits (MUEs) which are defined for many Healthcare Common Procedure Coding System (HCPCS) / Current Procedural Terminology (CPT) c...
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The HIPAA or Health Insurance Portability and Accountability Act of 1996, instructs medical healthcare plans to use the standard electronic transactions adopted under this agency b...