MC_PRICER_IOCE

Description:

Data returned from IOCE Editor.

Primary Key

Column Name	Ordinal Position
PRICER_MSG_ID	1

Column Information

	Name	Type	Discontinued?
1	PRICER_MSG_ID	NUMERIC	No
	The unique identifier for the Epic Pricer message record.
2	IOCE_RTN_CODE_C_NAME	VARCHAR	No
	IOCE return code. May contain organization-specific values: No Category Entries: Claim processed Memory allocation error Run-time environment initialization failed Could not open read-only table file Could not determine read-only table size No memory for read-only table Could not read read-only table file Read-only table file corrupted Read-only tables file wrong version Could not link tables to base object OCEInit not called before call to OCECLM Invalid number of line items Invalid "From" date Invalid "Through" date Invalid date sequence Invalid line date "From" date outside version range Invalid type of bill Claim not processed, bill type 12x or 14x present with CC 41 Contractor bypass edit is not able to be bypassed Invalid format used for contractor bypass input values Input format is incorrect for value code amount field Invalid claims processing receipt date
3	IOCE_PROCESSD_C_NAME	VARCHAR	No
	IOCE processed flag. May contain organization-specific values: No Category Entries: Claim processed Claim not processed: invalid date (edits 23, 24, 119); inappropriate bill type/condition code combination (edit 46); invalid bill type (118) Claim not processed: no line items present Claim could not be processed (Reserved) Fatal error; Contractor bypass issue, claim could not be processed; exit immediately A fatal error has been detected during initialization; processing should be terminated immediately
4	IOCE_CLM_DISP_C_NAME	VARCHAR	No
	IOCE claim disposition. May contain organization-specific values: No Category Entries: No edits are present on the claim The only edits present are for line item denial or rejection Claim is for multiple days with one or more days denied or rejected Claim is denied, rejected, suspended or returned to provider, or single day claim with all line items denied or rejected, with only post-payment edits Claim is denied, rejected, suspended or returned to provider, or single day claim with all line items denied or rejected, with only pre-payment edits Claim is denied, rejected, suspended or returned to provider, or single day claim with all line items denied or rejected, with both post- and pre- payment edits
5	IOCE_PAY_APC	VARCHAR	No
	IOCE payment APC.
6	IOCE_STATUS_IND_C_NAME	VARCHAR	No
	IOCE status indicator. May contain organization-specific values: No Category Entries: Services not paid under OPPS; paid under fee schedule or other payment system Non-allowed item or service for OPPS Inpatient procedure Non-allowed item or services Non-allowed item or service Items and services for which pricing information and claims data are not available Corneal tissue acquisition; certain CRNA services Drug/biological pass-through Pass-through device categories Outpatient department services paid through a comprehensive APC Hospital Part B services that may be paid through a comprehensive APC Non pass-through drugs and non-implantable biologicals, including therapeutic radiopharmaceuticals Influenza Vaccine; Pneumococcal Pneumonia Vaccine; Hepatitis B Vaccines; Covid-19 Vaccine; Monoclonal Antibody Therapy Product Service not billable to the MAC Items and services packaged into APC rates Partial Hospitalization or Intensive Outpatient Program STV-packaged codes T-packaged codes Codes that may be paid through a composite APC Conditionally packaged laboratory services Blood and blood products Significant procedure not subject to multiple procedure discounting Significant procedure subject to multiple procedure discounting Brachytherapy sources Clinic or emergency department visit Invalid HCPCS or invalid revenue code with blank HCPCS Non-implantable DME Valid revenue code with blank HCPCS and no other SI assigned Unknown Value
7	IOCE_PAYMENT_IND_C_NAME	VARCHAR	No
	IOCE payment indicator. May contain organization-specific values: No Category Entries: Paid standard hospital OPPS amount Services not paid by OPPS Pricer; paid under fee schedule or other payment system Not paid, or not paid under OPPS Paid at reasonable cost Paid standard amount for pass-through drug or biological Payment based on charge adjusted to cost Additional payment for new drug or new biological Paid partial hospitalization per diem No additional payment; payment included in line items with APCs Paid FQHC encounter payment Not paid or not included under FQHC encounter payment No additional payment, included in payment for FQHC encounter Paid FQHC encounter payment for new patient or IPPE/AWV Grandfathered tribal FQHC encounter payment FQHC IOP encounter payment Wrap-around payment for FQHCs that contract with Medicare Advantage (MA) organizations Unknown Value
8	IOCE_DISC_FLAG_C_NAME	VARCHAR	No
	IOCE discount flag. May contain organization-specific values: No Category Entries: 1.0 (1.0 + D(U-1))/U T/U (1 + D)/U D TD/U (Discontinued 1/1/2008, v9.0) D(1 + D)/U (Discontinued 1/1/2008, v9.0) 2.0 2D Unknown Value
9	IOCE_DENY_REJECT_C_NAME	VARCHAR	No
	IOCE Deny or Reject flag. May contain organization-specific values: No Category Entries: Line item not denied or rejected Line item denied or rejected The line is not denied or rejected, but occurs on a day that has been denied or rejected Line item not denied or rejected; identified for informational alert only Unknown Value