Question

A patient had a right-posterior subcapsular cataract extraction done with phacoemulsification. An anterior chamber intraocular lens was inserted during the same operative session. The claim is returned with OCE edit 71.

You will need to do the following:

Create a line item for the chargemaster that will resolve this issue in the future.

Explain what does Odit 71 mean?

Answer 1

OCE is the out patient editor created and its being maintained by CMS(corporate reimbursement scheme) OCE has some of the edits in the numerical form which tells that the patient cannot claim for the reimbursement due to lack of the documentation required to be submitted. Under this OCE edit 71 is the category which states claim lacks required device code under the 4 RTP(return to provider).

The line item which for the charge master that will resolve the issue are# providing him with the checklist which can make him go through the document require for claiming# awareness and in service education on the Appendices related to OCE categories to be provided in depth with new rules and policies. #the charge Master could be trained for the better documentation.