v2+ Vocabulary
0.3.0 - Working Draft to present the concept ideas (FO)
v2+ Vocabulary
0.3.0 - Working Draft to present the concept ideas (FO)
v2+ Vocabulary - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Active as of 2025-08-05 |
<CodeSystem xmlns="http://hl7.org/fhir">
<id value="cms-OCEEditCode-csV100"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><ul><li>Include all codes defined in <a href="CodeSystem-cms-OCEEditCode-csV100.html"><code>http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-csV100</code></a></li></ul></div>
</text>
<extension
url="http://terminology.hl7.org/v2plusvocab/StructureDefinition/codesystem-v2versionCreated">
<valueString value="2.4"/>
</extension>
<extension
url="http://terminology.hl7.org/v2plusvocab/StructureDefinition/codesystem-versionHistory">
<valueString value="generate correct history somehow"/>
</extension>
<extension
url="http://terminology.hl7.org/v2plusvocab/StructureDefinition/codesystem-tableNo">
<valueString value="0458"/>
</extension>
<url
value="http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-csV100"/>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:oid:2.16.840.1.113883.6.301.9"/>
</identifier>
<version value="1.0.0"/>
<name value="Cms-OCEEditCode-csV100"/>
<title value="OCE Edit Code (2.4 - 1.0.0)"/>
<status value="active"/>
<experimental value="true"/>
<date value="2025-08-05T15:14:51+02:00"/>
<description
value="Code system of concepts specifying the action to be taken during reimbursement calculations. Used in HL7 Version 2.x messaging in the GP2 segment."/>
<copyright value="HL7 Inc., 2024"/>
<caseSensitive value="true"/>
<content value="complete"/>
<property>
<code value="versionIntroduced"/>
<uri
value="http://terminology.hl7.org/v2plusvocab/CodeSystem/Property#versionIntroduced"/>
<description value="version when was this code introduced"/>
<type value="string"/>
</property>
<property>
<code value="versionDeprecated"/>
<uri
value="http://terminology.hl7.org/v2plusvocab/CodeSystem/Property#versionDeprecated"/>
<description value="version when was this code deprecated"/>
<type value="string"/>
</property>
<property>
<code value="status"/>
<uri value="http://hl7.org/fhir/concept-properties#status"/>
<description
value="A code that indicates the status of the concept. Typical values are active, experimental, deprecated, and retired"/>
<type value="code"/>
</property>
<property>
<code value="comment"/>
<uri
value="http://terminology.hl7.org/v2plusvocab/CodeSystem/Property#comment"/>
<description
value="A string that provides additional detail pertinent to the use or understanding of the concept"/>
<type value="string"/>
</property>
<property>
<code value="usage"/>
<uri
value="http://terminology.hl7.org/v2plusvocab/CodeSystem/Property#usage"/>
<description value="usage notes for this code"/>
<type value="string"/>
</property>
<property>
<code value="modified"/>
<uri
value="http://terminology.hl7.org/v2plusvocab/CodeSystem/Property#modified"/>
<description value="date of last modification"/>
<type value="dateTime"/>
</property>
<concept>
<code value="1"/>
<display value="Invalid diagnosis code"/>
<definition value="Invalid diagnosis code"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="10"/>
<display
value="Non-covered service submitted for verification of denial (condition code 21 from header information on claim)"/>
<definition
value="Non-covered service submitted for verification of denial (condition code 21 from header information on claim)"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="11"/>
<display
value="Non-covered service submitted for FI review (condition code 20 from header information on claim)"/>
<definition
value="Non-covered service submitted for FI review (condition code 20 from header information on claim)"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="12"/>
<display value="Questionable covered service"/>
<definition value="Questionable covered service"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="13"/>
<display value="Additional payment for service not provided by Medicare"/>
<definition
value="Additional payment for service not provided by Medicare"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="14"/>
<display value="Code indicates a site of service not included in OPPS"/>
<definition
value="Code indicates a site of service not included in OPPS"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="15"/>
<display value="Service unit out of range for procedure"/>
<definition value="Service unit out of range for procedure"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="16"/>
<display
value="Multiple bilateral procedures without modifier 50 (see Appendix A)"/>
<definition
value="Multiple bilateral procedures without modifier 50 (see Appendix A)"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="17"/>
<display
value="Multiple bilateral procedures with modifier 50 (see Appendix A)"/>
<definition
value="Multiple bilateral procedures with modifier 50 (see Appendix A)"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="18"/>
<display value="Inpatient procedure"/>
<definition value="Inpatient procedure"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="19"/>
<display
value="Mutually exclusive procedure that is not allowed even if appropriate modifier present"/>
<definition
value="Mutually exclusive procedure that is not allowed even if appropriate modifier present"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="2"/>
<display value="Diagnosis and age conflict"/>
<definition value="Diagnosis and age conflict"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="20"/>
<display
value="Component of a comprehensive procedure that is not allowed even if appropriate modifier present"/>
<definition
value="Component of a comprehensive procedure that is not allowed even if appropriate modifier present"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="21"/>
<display
value="Medical visit on same day as a type "T" or "S" procedure without modifier 25 (see Appendix B)"/>
<definition
value="Medical visit on same day as a type "T" or "S" procedure without modifier 25 (see Appendix B)"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="22"/>
<display value="Invalid modifier"/>
<definition value="Invalid modifier"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="23"/>
<display value="Invalid date"/>
<definition value="Invalid date"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="24"/>
<display value="Date out of OCE range"/>
<definition value="Date out of OCE range"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="25"/>
<display value="Invalid age"/>
<definition value="Invalid age"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="26"/>
<display value="Invalid sex"/>
<definition value="Invalid sex"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="27"/>
<display value="Only incidental services reported"/>
<definition value="Only incidental services reported"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="28"/>
<display
value="Code not recognized by Medicare; alternate code for same service available"/>
<definition
value="Code not recognized by Medicare; alternate code for same service available"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="29"/>
<display
value="Partial hospitalization service for non-mental health diagnosis"/>
<definition
value="Partial hospitalization service for non-mental health diagnosis"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="3"/>
<display value="Diagnosis and sex conflict"/>
<definition value="Diagnosis and sex conflict"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="30"/>
<display value="Insufficient services on day of partial hospitalization"/>
<definition
value="Insufficient services on day of partial hospitalization"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="31"/>
<display
value="Partial hospitalization on same day as ECT or type "T" procedure"/>
<definition
value="Partial hospitalization on same day as ECT or type "T" procedure"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="32"/>
<display
value="Partial hospitalization claim spans 3 or less days with in-sufficient services, or ECT or significant procedure on at least one of the days"/>
<definition
value="Partial hospitalization claim spans 3 or less days with in-sufficient services, or ECT or significant procedure on at least one of the days"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="33"/>
<display
value="Partial hospitalization claim spans more than 3 days with insufficient number of days having mental health services"/>
<definition
value="Partial hospitalization claim spans more than 3 days with insufficient number of days having mental health services"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="34"/>
<display
value="Partial hospitalization claim spans more than 3 days with insufficient number of days meeting partial hospitalization criteria"/>
<definition
value="Partial hospitalization claim spans more than 3 days with insufficient number of days meeting partial hospitalization criteria"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="35"/>
<display
value="Only activity therapy and/or occupational therapy services provided"/>
<definition
value="Only activity therapy and/or occupational therapy services provided"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="36"/>
<display
value="Extensive mental health services provided on day of ECT or significant procedure"/>
<definition
value="Extensive mental health services provided on day of ECT or significant procedure"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="37"/>
<display
value="Terminated bilateral procedure or terminated procedure with units greater than one"/>
<definition
value="Terminated bilateral procedure or terminated procedure with units greater than one"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="38"/>
<display
value="Inconsistency between implanted device and implantation procedure"/>
<definition
value="Inconsistency between implanted device and implantation procedure"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="39"/>
<display
value="Mutually exclusive procedure that would be allowed if appropriate modifier were present"/>
<definition
value="Mutually exclusive procedure that would be allowed if appropriate modifier were present"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="4"/>
<display value="Medicare secondary payer alert"/>
<definition value="Medicare secondary payer alert"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="40"/>
<display
value="Component of a comprehensive procedure that would be allowed if appropriate modifier were present"/>
<definition
value="Component of a comprehensive procedure that would be allowed if appropriate modifier were present"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="41"/>
<display value="Invalid revenue code"/>
<definition value="Invalid revenue code"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="42"/>
<display
value="Multiple medical visits on same day with same revenue code without condition code G0 (see Appendix B)"/>
<definition
value="Multiple medical visits on same day with same revenue code without condition code G0 (see Appendix B)"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="5"/>
<display value="E-code as reason for visit"/>
<definition value="E-code as reason for visit"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="6"/>
<display value="Invalid procedure code"/>
<definition value="Invalid procedure code"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="7"/>
<display value="Procedure and age conflict"/>
<definition value="Procedure and age conflict"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="8"/>
<display value="Procedure and sex conflict"/>
<definition value="Procedure and sex conflict"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
<concept>
<code value="9"/>
<display value="Nov-covered service"/>
<definition value="Nov-covered service"/>
<property>
<code value="versionIntroduced"/>
<valueString value="2.4"/>
</property>
</concept>
</CodeSystem>