The outpatient code editor (OCE) archive list is used in addition to our existing medical policy clinical edits and follows our current reimbursement policies. These edits are modeled after the Centers for Medicare & Medicaid Services' (CMS') existing non-outpatient prospective payment system (non-OPPS) OCE edits. These edits apply to all Medicare Advantage plans and commercial lines of business, including Federal Employee Program, Uniform Medical Plan and BlueCard®.

New edits published by CMS will take effect based on CMS's published effective date and we will follow our existing process to post updates on a monthly basis in the Coding Toolkit.