FHIR IG analytics| Package | hl7.v2.uv.terminology.v281 |
| Resource Type | CodeSystem |
| Id | CodeSystem-cms-OCEEditCode-cs.json |
| FHIR Version | R4 |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
FHIR
FHIRsmithhttp://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs{
"resourceType": "CodeSystem",
"id": "cms-OCEEditCode-cs",
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"url": "http://terminology.hl7.org/v2plusvocab/StructureDefinition/codesystem-v2versionCreated",
"valueString": "2.8.1"
},
{
"url": "http://terminology.hl7.org/v2plusvocab/StructureDefinition/codesystem-versionHistory",
"valueString": "generate correct history somehow"
},
{
"url": "http://terminology.hl7.org/v2plusvocab/StructureDefinition/codesystem-tableNo",
"valueString": "0458"
}
],
"url": "http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs",
"identifier": [
{
"system": "urn:ietf:rfc:3986",
"value": "urn:oid:2.16.840.1.113883.6.301.9"
}
],
"version": "1.0.0",
"name": "Cms-OCEEditCode-cs",
"title": "OCE Edit Code (2.8.1 - 1.0.0)",
"status": "active",
"experimental": true,
"date": "2026-01-27T19:45:38+00:00",
"publisher": "HL7/FO",
"contact": [
{
"name": "HL7/FO",
"telecom": [
{
"system": "url",
"value": "http://www.hl7.org"
}
]
}
],
"description": "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": "HL7 Inc., 2026",
"caseSensitive": true,
"compositional": false,
"content": "complete",
"property": [
{
"code": "versionIntroduced",
"uri": "http://terminology.hl7.org/v2plusvocab/CodeSystem/Property#versionIntroduced",
"description": "version when was this code introduced",
"type": "string"
},
{
"code": "versionDeprecated",
"uri": "http://terminology.hl7.org/v2plusvocab/CodeSystem/Property#versionDeprecated",
"description": "version when was this code deprecated",
"type": "string"
},
{
"code": "status",
"uri": "http://hl7.org/fhir/concept-properties#status",
"description": "A code that indicates the status of the concept. Typical values are active, experimental, deprecated, and retired",
"type": "code"
},
{
"code": "comment",
"uri": "http://terminology.hl7.org/v2plusvocab/CodeSystem/Property#comment",
"description": "A string that provides additional detail pertinent to the use or understanding of the concept",
"type": "string"
},
{
"code": "usage",
"uri": "http://terminology.hl7.org/v2plusvocab/CodeSystem/Property#usage",
"description": "usage notes for this code",
"type": "string"
},
{
"code": "modified",
"uri": "http://terminology.hl7.org/v2plusvocab/CodeSystem/Property#modified",
"description": "date of last modification",
"type": "dateTime"
}
],
"concept": [
{
"code": "1",
"display": "Invalid diagnosis code",
"definition": "Invalid diagnosis code",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "10",
"display": "Non-covered service submitted for verification of denial (condition code 21 from header information on claim)",
"definition": "Non-covered service submitted for verification of denial (condition code 21 from header information on claim)",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "11",
"display": "Non-covered service submitted for FI review (condition code 20 from header information on claim)",
"definition": "Non-covered service submitted for FI review (condition code 20 from header information on claim)",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "12",
"display": "Questionable covered service",
"definition": "Questionable covered service",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "13",
"display": "Additional payment for service not provided by Medicare",
"definition": "Additional payment for service not provided by Medicare",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "14",
"display": "Code indicates a site of service not included in OPPS",
"definition": "Code indicates a site of service not included in OPPS",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "15",
"display": "Service unit out of range for procedure",
"definition": "Service unit out of range for procedure",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "16",
"display": "Multiple bilateral procedures without modifier 50 (see Appendix A)",
"definition": "Multiple bilateral procedures without modifier 50 (see Appendix A)",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "17",
"display": "Multiple bilateral procedures with modifier 50 (see Appendix A)",
"definition": "Multiple bilateral procedures with modifier 50 (see Appendix A)",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "18",
"display": "Inpatient procedure",
"definition": "Inpatient procedure",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "19",
"display": "Mutually exclusive procedure that is not allowed even if appropriate modifier present",
"definition": "Mutually exclusive procedure that is not allowed even if appropriate modifier present",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "2",
"display": "Diagnosis and age conflict",
"definition": "Diagnosis and age conflict",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "20",
"display": "Component of a comprehensive procedure that is not allowed even if appropriate modifier present",
"definition": "Component of a comprehensive procedure that is not allowed even if appropriate modifier present",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "21",
"display": "Medical visit on same day as a type \"T\" or \"S\" procedure without modifier 25 (see Appendix B)",
"definition": "Medical visit on same day as a type \"T\" or \"S\" procedure without modifier 25 (see Appendix B)",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "22",
"display": "Invalid modifier",
"definition": "Invalid modifier",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "23",
"display": "Invalid date",
"definition": "Invalid date",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "24",
"display": "Date out of OCE range",
"definition": "Date out of OCE range",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "25",
"display": "Invalid age",
"definition": "Invalid age",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "26",
"display": "Invalid sex",
"definition": "Invalid sex",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "27",
"display": "Only incidental services reported",
"definition": "Only incidental services reported",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "28",
"display": "Code not recognized by Medicare; alternate code for same service available",
"definition": "Code not recognized by Medicare; alternate code for same service available",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "29",
"display": "Partial hospitalization service for non-mental health diagnosis",
"definition": "Partial hospitalization service for non-mental health diagnosis",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "3",
"display": "Diagnosis and sex conflict",
"definition": "Diagnosis and sex conflict",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "30",
"display": "Insufficient services on day of partial hospitalization",
"definition": "Insufficient services on day of partial hospitalization",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "31",
"display": "Partial hospitalization on same day as ECT or type \"T\" procedure",
"definition": "Partial hospitalization on same day as ECT or type \"T\" procedure",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "32",
"display": "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": "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": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "33",
"display": "Partial hospitalization claim spans more than 3 days with insufficient number of days having mental health services",
"definition": "Partial hospitalization claim spans more than 3 days with insufficient number of days having mental health services",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "34",
"display": "Partial hospitalization claim spans more than 3 days with insufficient number of days meeting partial hospitalization criteria",
"definition": "Partial hospitalization claim spans more than 3 days with insufficient number of days meeting partial hospitalization criteria",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "35",
"display": "Only activity therapy and/or occupational therapy services provided",
"definition": "Only activity therapy and/or occupational therapy services provided",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "36",
"display": "Extensive mental health services provided on day of ECT or significant procedure",
"definition": "Extensive mental health services provided on day of ECT or significant procedure",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "37",
"display": "Terminated bilateral procedure or terminated procedure with units greater than one",
"definition": "Terminated bilateral procedure or terminated procedure with units greater than one",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "38",
"display": "Inconsistency between implanted device and implantation procedure",
"definition": "Inconsistency between implanted device and implantation procedure",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "39",
"display": "Mutually exclusive procedure that would be allowed if appropriate modifier were present",
"definition": "Mutually exclusive procedure that would be allowed if appropriate modifier were present",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "4",
"display": "Medicare secondary payer alert",
"definition": "Medicare secondary payer alert",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "40",
"display": "Component of a comprehensive procedure that would be allowed if appropriate modifier were present",
"definition": "Component of a comprehensive procedure that would be allowed if appropriate modifier were present",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "41",
"display": "Invalid revenue code",
"definition": "Invalid revenue code",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "42",
"display": "Multiple medical visits on same day with same revenue code without condition code G0 (see Appendix B)",
"definition": "Multiple medical visits on same day with same revenue code without condition code G0 (see Appendix B)",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "5",
"display": "E-code as reason for visit",
"definition": "E-code as reason for visit",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "6",
"display": "Invalid procedure code",
"definition": "Invalid procedure code",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "7",
"display": "Procedure and age conflict",
"definition": "Procedure and age conflict",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "8",
"display": "Procedure and sex conflict",
"definition": "Procedure and sex conflict",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
},
{
"code": "9",
"display": "Nov-covered service",
"definition": "Nov-covered service",
"property": [
{
"code": "versionIntroduced",
"valueString": "2.4"
}
]
}
]
}