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CMS Manual System
CMS Manual System Department of Health & Human Services (DHHS) Pub 100-04 Medicare Claims Processing Centers for Medicare & Medicaid Services (CMS) Transmittal 10540 Date: December 31, 2020 Change Request 12114 SUBJECT: January 2021 Integrated Outpatient code Editor (I/OCE) Specifications Version I. SUMMARY OF CHANGES: This notification provides the Integrated OCE instructions and specifications for the Integrated OCE that will be utilized under the Outpatient Prospective Payment System (OPPS) and non-OPPS for hospital outpatient departments, community mental health centers, all non-OPPS providers, and for limited services when provided in a home health agency not under the Home Health Prospective Payment System or to a hospice patient for the treatment of a non-terminal illness.
The following ICD-10 code(s) were added to the Unacceptable Principal Diagnosis list (edit 113). Unacceptable Principal Diagnosis Additions. Reason Key: A=Added To List, N=New Code Diagnosis Eff Date Description R* J1282 2021-01-01 Pneumonia due to coronavirus disease 2019 N Z1152 2021-01-01 Encounter for screening for COVID-19 N
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