Transcription of Definitions of Medicare Code Edits - CMS
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Definitions of Medicare Code Edits - CMS
Definitions of Medicare code EditsDRAFT ICD-10 VERSIONS oftware version R1 PBL 031 September 2011 Manual updated March 2012ii Definitions of Medicare code EditsSeptember 2011 Document number PBL 031 September 2011 iiiSeptember 2011 About this documentTHE Medicare code editor (MCE) detects and reports errors in the coding claims data. This manual contains a description of each coding edit with corresponding ICD-10-CM and ICD-10-PCS code lists which were published in December 2010. The coding edit information in this manual is effective from 10/01/2010 to 09/30/2011. However it is not intended to be used to process claims as the ICD- 10 code set will not be mandated for use until October 1, Definitions of Medicare code EditsSeptember 2011 Contents vSeptember 2011 ContentsPrefaceAbout this document iiiChapter 1 Edit code lists Invalid diagnosis or procedure code External causes of morbidity codes as principal diagnosis Duplicate of PDX Age conflict Sex conflict Manifestation code as principal diagnosis Non-specific principal diagnosis Questionable admission Unacceptable principal diagnosis Non-specific procedure Non-covered procedure Open biopsy check Bilateral procedure Invalid age Inval
THE MEDICARE CODE EDITOR (MCE) detects and reports errors in the coding claims data. This manual contains a description of each coding edit with corresponding ICD-10-CM and ICD-10-PCS code lists which were published in December 2010. The coding edit information in this manual is effective from 10/01/2010 to 09/30/2011.
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