Coding professionals are also required to use HCPCS (Healthcare
Common Procedure Coding System) Codes to describe any service that a
medical practitioner may provide to a Medicare patient. These codes are
constantly monitored by the Centers for Medicare and Medicaid Services
(CMS).
The HCPCS is divided into two subsystems, known as level I and level II of the HCPCS.
Level I codes of the HCPCS are based on and are similar to the CPT® (Current Procedural Terminology) codes. The coding system (consisting of 5-digit numeric codes) is developed and maintained by the American Medical Association (AMA).
Level II of the HCPCS is used to describe products, supplies, and services that are not included in the CPT® codes, such as ambulance services and medical equipment, prosthetics, and supplies especially when they are used outside the physician’s office. To report the services and supplies that are not covered by CPT® codes, coders can use level II HCPCS codes. Level II HCPCS codes are also known as alpha-numeric codes as they are made up of a single letter plus 4 numeric digits.
Level II codes do not generally define the costs that were incurred by a physician’s office and hence are dealt differently by Medicare or Medicaid.
The HCPCS Level II was developed and came into use in the 1980s. Later on, in 2003, the Secretary of Health and Human Services (HHS) assigned an authority under the Health Insurance Portability & Accountability Act of 1996 (HIPAA) legislation to CMS to maintain and distribute HCPCS Level II codes. This code set is revised quarterly on the basis of feedback from the general public, providers, healthcare products manufacturers, vendors, etc.
It is interesting to note that the CPT® codes may crosswalk to HCPCS codes, but there is no equivalent for HCPCS in the ICD (International Classification of Diseases) manual.
The HCPCS is divided into two subsystems, known as level I and level II of the HCPCS.
Level I codes of the HCPCS are based on and are similar to the CPT® (Current Procedural Terminology) codes. The coding system (consisting of 5-digit numeric codes) is developed and maintained by the American Medical Association (AMA).
Level II of the HCPCS is used to describe products, supplies, and services that are not included in the CPT® codes, such as ambulance services and medical equipment, prosthetics, and supplies especially when they are used outside the physician’s office. To report the services and supplies that are not covered by CPT® codes, coders can use level II HCPCS codes. Level II HCPCS codes are also known as alpha-numeric codes as they are made up of a single letter plus 4 numeric digits.
Level II codes do not generally define the costs that were incurred by a physician’s office and hence are dealt differently by Medicare or Medicaid.
The HCPCS Level II was developed and came into use in the 1980s. Later on, in 2003, the Secretary of Health and Human Services (HHS) assigned an authority under the Health Insurance Portability & Accountability Act of 1996 (HIPAA) legislation to CMS to maintain and distribute HCPCS Level II codes. This code set is revised quarterly on the basis of feedback from the general public, providers, healthcare products manufacturers, vendors, etc.
It is interesting to note that the CPT® codes may crosswalk to HCPCS codes, but there is no equivalent for HCPCS in the ICD (International Classification of Diseases) manual.
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