HL7 v2.7 Vocabulary
0.2.0 - ci-build
HL7 v2.7 Vocabulary, published by HL7/FO. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/frankoemig/hl7.v2.terminology.v27/ and changes regularly. See the Directory of published versions
| Official URL: http://terminology.hl7.org/v2plusvocab/ValueSet/hl7VSOCEEditCode | Version: 1.0.0 | |||
| Active as of 2026-03-13 | Computable Name: Hl7VSOCEEditCode | |||
| Other Identifiers: OID:2.16.840.1.113883.21.470, urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#http://terminology.hl7.org/v2plusvocab/ValueSet/v2-0458 | ||||
Copyright/Legal: HL7 Inc., 2026 |
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Value Set of codes that specify the edits that result from processing the HCPCS/CPT procedures for a record after evaluating all the codes, revenue codes, and modifiers.
References
This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs version 📍1.0.0
Expansion performed internally based on codesystem OCE Edit Code (2.7 - 1.0.0) v1.0.0 (CodeSystem)
This value set contains 42 concepts
| System | Code | Display (en) | Definition | JSON | XML |
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 1 | Invalid diagnosis code | Invalid diagnosis code | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 10 | Non-covered service submitted for verification of denial (condition code 21 from header information on claim) | Non-covered service submitted for verification of denial (condition code 21 from header information on claim) | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 11 | Non-covered service submitted for FI review (condition code 20 from header information on claim) | Non-covered service submitted for FI review (condition code 20 from header information on claim) | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 12 | Questionable covered service | Questionable covered service | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 13 | Additional payment for service not provided by Medicare | Additional payment for service not provided by Medicare | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 14 | Code indicates a site of service not included in OPPS | Code indicates a site of service not included in OPPS | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 15 | Service unit out of range for procedure | Service unit out of range for procedure | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 16 | Multiple bilateral procedures without modifier 50 (see Appendix A) | Multiple bilateral procedures without modifier 50 (see Appendix A) | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 17 | Multiple bilateral procedures with modifier 50 (see Appendix A) | Multiple bilateral procedures with modifier 50 (see Appendix A) | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 18 | Inpatient procedure | Inpatient procedure | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 19 | Mutually exclusive procedure that is not allowed even if appropriate modifier present | Mutually exclusive procedure that is not allowed even if appropriate modifier present | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 2 | Diagnosis and age conflict | Diagnosis and age conflict | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 20 | Component of a comprehensive procedure that is not allowed even if appropriate modifier present | Component of a comprehensive procedure that is not allowed even if appropriate modifier present | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 21 | Medical visit on same day as a type "T" or "S" procedure without modifier 25 (see Appendix B) | Medical visit on same day as a type "T" or "S" procedure without modifier 25 (see Appendix B) | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 22 | Invalid modifier | Invalid modifier | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 23 | Invalid date | Invalid date | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 24 | Date out of OCE range | Date out of OCE range | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 25 | Invalid age | Invalid age | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 26 | Invalid sex | Invalid sex | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 27 | Only incidental services reported | Only incidental services reported | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 28 | Code not recognized by Medicare; alternate code for same service available | Code not recognized by Medicare; alternate code for same service available | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 29 | Partial hospitalization service for non-mental health diagnosis | Partial hospitalization service for non-mental health diagnosis | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 3 | Diagnosis and sex conflict | Diagnosis and sex conflict | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 30 | Insufficient services on day of partial hospitalization | Insufficient services on day of partial hospitalization | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 31 | Partial hospitalization on same day as ECT or type "T" procedure | Partial hospitalization on same day as ECT or type "T" procedure | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 32 | Partial hospitalization claim spans 3 or less days with in-sufficient services, or ECT or significant procedure on at least one of the days | Partial hospitalization claim spans 3 or less days with in-sufficient services, or ECT or significant procedure on at least one of the days | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 33 | Partial hospitalization claim spans more than 3 days with insufficient number of days having mental health services | Partial hospitalization claim spans more than 3 days with insufficient number of days having mental health services | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 34 | Partial hospitalization claim spans more than 3 days with insufficient number of days meeting partial hospitalization criteria | Partial hospitalization claim spans more than 3 days with insufficient number of days meeting partial hospitalization criteria | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 35 | Only activity therapy and/or occupational therapy services provided | Only activity therapy and/or occupational therapy services provided | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 36 | Extensive mental health services provided on day of ECT or significant procedure | Extensive mental health services provided on day of ECT or significant procedure | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 37 | Terminated bilateral procedure or terminated procedure with units greater than one | Terminated bilateral procedure or terminated procedure with units greater than one | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 38 | Inconsistency between implanted device and implantation procedure | Inconsistency between implanted device and implantation procedure | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 39 | Mutually exclusive procedure that would be allowed if appropriate modifier were present | Mutually exclusive procedure that would be allowed if appropriate modifier were present | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 4 | Medicare secondary payer alert | Medicare secondary payer alert | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 40 | Component of a comprehensive procedure that would be allowed if appropriate modifier were present | Component of a comprehensive procedure that would be allowed if appropriate modifier were present | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 41 | Invalid revenue code | Invalid revenue code | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 42 | Multiple medical visits on same day with same revenue code without condition code G0 (see Appendix B) | Multiple medical visits on same day with same revenue code without condition code G0 (see Appendix B) | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 5 | E-code as reason for visit | E-code as reason for visit | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 6 | Invalid procedure code | Invalid procedure code | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 7 | Procedure and age conflict | Procedure and age conflict | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 8 | Procedure and sex conflict | Procedure and sex conflict | ||
http://terminology.hl7.org/v2plusvocab/CodeSystem/cms-OCEEditCode-cs | 9 | Nov-covered service | Nov-covered service |
Explanation of the columns that may appear on this page:
| Level | A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies |
| System | The source of the definition of the code (when the value set draws in codes defined elsewhere) |
| Code | The code (used as the code in the resource instance) |
| Display | The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application |
| Definition | An explanation of the meaning of the concept |
| Comments | Additional notes about how to use the code |