Healthcare Common Procedure Coding System
Healthcare Common Procedure Coding System (HCPCS) is divided into two distinct subgroups: Level I and Level II HCPCs. Level I is made up of the Current Procedural Terminology Category (CPT)codes. CPT codes are used to bill public or private insurances programs for medical services and procedures.
Level II HCPCS is the standard of coding used to identify products, supplies, and services not included in the CPT. These include transportation services, durable medical equipment (DME), prosthetics, orthotics, and supplies.
Level II HCPCS were developed in the 1980’s. The codes are alpha-numeric consisting of a letter followed by 4 numbers. CPT codes, on the other hand, are 5 digit numeric codes.
According to the AAPC website HCPCS Level II is …show more content…
sometimes described as the “hall closet of coding”. (AAPC, 2016)
The use of HCPCS Level II standardizes the classification of medical goods and services not included in the CPT codes to facilitate efficient processing of insurance claims. However, the existence of an HCPCS code does not in itself determine payment or imply coverage and decisions to add, delete or revise HCPCS codes is made independently from the process of determining coverage or payment.
There are various types of HCPCS Level II codes in brief they are
Permeant and Temporary National Codes
Dental Codes
Miscellaneous Codes
Permanent National HCPCS Level II codes are maintained by the CMS HCPCS Workgroup that is comprised of representatives of the private insurance carriers and Medicaid agencies, CMS staff and contractors and the US, DHSS Department of Veterans Affairs.
Dental Codes or Current Dental Terminology (CDT) are maintained, published and copyrighted by the American Dental Association.
Like CPT codes, the use of Modifiers is employed to provide additional information that the code itself does not contain. These modifiers can be alpha-numeric or two letters. Two examples that are unlike CPT modifiers are UE which indicates used equipment and NU which identifies new equipment.
The AAPC adds this to explain the function of HCPCS Level II “This coding system is also used as an official code set for outpatient hospital care, chemotherapy drugs, Medicaid, and other services. The Blue Cross Blue Shield Association and the American Dental Association (ADA) post their procedure codes as part of HCPCS Level II. The Centers for Medicare & Medicaid Services (CMS) regularly uses HCPCS Level II to post codes for the tracking of demonstration projects and new technologies.” (AAPC,
2016)
HCPCS Level II codes are like the hall closet. A place for important codes that don’t fit anyplace else.
References
AAPC. (2016). HCPCS Medical Coding - HCPCS Codes - AAPC. Retrieved from https://www.aapc.com/resources/medical-coding/hcpcs.aspx
Centers for Medicare & Medicaid Services. (2000, August 17). HCPCS - General information downloads PDF. Retrieved from https://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/Downloads/HCPCSLevelIICodingProcedures7-2011.pdf
Level II HCPCS is the standard of coding used to identify products, supplies, and services not included in the CPT. These include transportation services, durable medical equipment (DME), prosthetics, orthotics, and supplies.
Level II HCPCS were developed in the 1980’s. The codes are alpha-numeric consisting of a letter followed by 4 numbers. CPT codes, on the other hand, are 5 digit numeric codes.
According to the AAPC website HCPCS Level II is …show more content…
sometimes described as the “hall closet of coding”. (AAPC, 2016)
The use of HCPCS Level II standardizes the classification of medical goods and services not included in the CPT codes to facilitate efficient processing of insurance claims. However, the existence of an HCPCS code does not in itself determine payment or imply coverage and decisions to add, delete or revise HCPCS codes is made independently from the process of determining coverage or payment.
There are various types of HCPCS Level II codes in brief they are
Permeant and Temporary National Codes
Dental Codes
Miscellaneous Codes
Permanent National HCPCS Level II codes are maintained by the CMS HCPCS Workgroup that is comprised of representatives of the private insurance carriers and Medicaid agencies, CMS staff and contractors and the US, DHSS Department of Veterans Affairs.
Dental Codes or Current Dental Terminology (CDT) are maintained, published and copyrighted by the American Dental Association.
Like CPT codes, the use of Modifiers is employed to provide additional information that the code itself does not contain. These modifiers can be alpha-numeric or two letters. Two examples that are unlike CPT modifiers are UE which indicates used equipment and NU which identifies new equipment.
The AAPC adds this to explain the function of HCPCS Level II “This coding system is also used as an official code set for outpatient hospital care, chemotherapy drugs, Medicaid, and other services. The Blue Cross Blue Shield Association and the American Dental Association (ADA) post their procedure codes as part of HCPCS Level II. The Centers for Medicare & Medicaid Services (CMS) regularly uses HCPCS Level II to post codes for the tracking of demonstration projects and new technologies.” (AAPC,
2016)
HCPCS Level II codes are like the hall closet. A place for important codes that don’t fit anyplace else.
References
AAPC. (2016). HCPCS Medical Coding - HCPCS Codes - AAPC. Retrieved from https://www.aapc.com/resources/medical-coding/hcpcs.aspx
Centers for Medicare & Medicaid Services. (2000, August 17). HCPCS - General information downloads PDF. Retrieved from https://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/Downloads/HCPCSLevelIICodingProcedures7-2011.pdf