OCEActive Code Editor Components
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Overview:
With the increased use of HMO’s, ambulatory surgicenters, preferred provider organizations, emergency rooms, and hospital outpatient departments, accurate coding for ambulatory care is a necessity.
The OCEActive™ Enterprise Code Editor DLL (for Non-OPPS claims) was developed to ensure accurate coding by detecting potential problems in the coding of claims data according to CMS specifications. Diagnoses are coded in ICD-9-CM classification; procedures are coded in HCPCS classification. OCEActive™ screens each procedure code against a list of approximately 2500 ASC procedures, a list of Out of Scope procedures, and the entire CPT code list, including all recent releases. OCEActive™ also summarizes whether or not the bill is subject to the ASC limitation and which edit conditions apply.
Software developers and system integrators! The OCEActive™ Enterprise Code Editor DLL (for Non-OPPS claims) is the easiest way to add complete CMS-compliant data validation to your systems or applications. By simply incorporating the OCEActive™ Enterprise Code Editor DLL into your application, setting the input property values, and executing the CodeEdit method you can easily validate your input claim data elements. The editing performed by OCEActive™ is 100% compliant with CMS specifications. These 32-bit or 64-bit components allow you to add data validation to your systems and applications built for the Windows client environment.
The OCEActive™ Enterprise Code Editor DLL (for Non-OPPS claims) is an ideal solution for claims processing applications, data warehousing and data analysis, claim review, compliance auditing, and much more.
Availability:
- The OCEActive™ Enterprise Code Editor DLL is available in a 32-bit or 64-bit .Net or ActiveX format and utilizes Microsoft SQL Server 2000/2005/2008 data components for high-performance in large-scale enterprise and web-based applications. This module covers five fiscal years (FY03-07) of data validation specifications.
| 1. Invalid Diagnosis or Procedure Code | 11. Diagnoses allowed for females only |
| 2. Invalid Age | 12. Procedure allowed for females only |
| 3. Invalid Sex | 13. Non-Covered Procedure |
| 4. E-Code as Principal Diagnosis | 14. Questionable Covered Procedure |
| 5. Diagnoses for Newborns and Neonates | 15. Conflict Cataract Procedure |
| 6. Pediatric diagnoses for children up to17 | 16. ASC Procedure |
| 7. Maternity diagnoses | 17. Out of Scope Procedure |
| 8. Adult diagnoses for age > 15 | 18. Non-reportable Codes |
| 9. Diagnoses allowed for males only | 19. Unlisted Procedure |
| 10. Procedures allowed for males only | 20. Non Subject To Limitation |
Compatible with the leading Windows development environments including:
Microsoft Visual
Studio .Net/2005/2008 (32-bit or 64-bit)
Microsoft Visual Studio 6.0
MS Access
Licensing:
The OCEActive™ Enterprise Code Editor DLL (for Non-OPPS claims) is licensed based upon usage.
- For a single site installation, like a health plan, hospital, or university, OCEActive™ is licensed for internal use based on the size of the installation.
- For a Software Developer including OCEActive™ in a software package for distribution to an end user, a distribution agreement is required. Terms: an initial license fee and a per-site fee for each OCEActive™ component.