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Costing and Submission Updates

Methodology Changes

i. Cancer Care Ontario (CCO) Rebates: CCO rebates recorded under a 11* account should be treated as a revenue account and not netted against expenses.

ii. Lab and Diagnostic Service Dates: The order date or the result date can be used as the Lab and Diagnostic service dates. Service costs should be reported from
   admit date up to 30 days following discharge.

iii. Community Funding (Fund Type 2): The administrative cost for Community Funding/Fund Type 2 should be allocated to the patients in the related functional centre.
     In addition, the Fund Type 2 patients should also receive a portion of the indirect costs from other administrative areas.

iv. Lab and Diagnostic Referred-In Service: Lab and DI Referred-In revenue should be excluded, and the Referred-In Service expense and workload should be included.

v. Patient Hours or Nursing Hours Cost Distribution: Effective September 1,2006 facilities may choose between patient or nursing hours to allocate nursing costs.
   For more information, please refer to the Ontario Guide to Case Costing.

Download Data Submission Guidelines Version 6.0

Audit Changes

i. Nursing Costs

Nursing costs must be reported for a minimum of 90% of the patient's time in hospital. Due to nursing shifts that include two calendar days, nursing costs may
be omitted from the admit day and reported on the second day of stay.

Nursing costs must be reported for each day of stay including the admit date for the following Functional Centres:

  • from 7*2400000 to 7*2999999;
  • from 7*3400000 to 7*3500000;
  • functional centre 7*2765000, and
  • 7*310*

ii. Service Date

Cases should not contain cost for service dates pre-admit or post discharge, with the following exceptions in acute inpatient and ambulatory care:

Acute Inpatient & Ambulatory Care

  • Nursing, Allied Health, Lab, DI, and Pharmacy for one (1) day prior to admission
  • Pharmacy for two (2) days prior to admission
  • Nursing for one (1) day after discharge
  • Lab and DI records should be kept for up to 120 days following discharge
  • Allied Health records should be kept for up to 120 days following discharge.

iii. Emergency Inpatients Costs

Facilities that combine emergency costs with ER inpatient costs should exclude the first day of service from the ER inpatient case record (7*310*).

iv. Pharmacy Credits

Pharmacy credits should be reported in the following format:

-99999.00

v. Supply Costs

Case records with supply costs less than the OCCI standard listed below will not be accepted.

  • Hip and Knee-Inpatient
    Procedure code = IVA53*, IVG53*
    Criteria: Functional Centre=7*260*
    Patient specific supply costs must be greater than $1500
  • Pacemaker-Inpatient
    Procedure code = IHZ53GRNK
    Criteria: Functional Centre = 7*26042*
    Patient specific supply costs must be greater than $3000
  • Cataracts-Day SurgerY
    Procedure code = ICL8VRLN, ICL89VRLM
    Criteria: Functional Centre = 7*260*, 7*262*, 7*34020*, 7*34025*, 7*340557*
    VDS (Patient Specific)- must be greater than $100


For a listing of all OCCI audits, see OCCI Data Compliance and Review Guide