Live or Die by the Guidelines: HCPCS Level II · Live or Die by the Guidelines: HCPCS Level II ... •HCPCS Level II, supplemental codes for supplies and procedures •HCPCS Level
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
All Rights Reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use.
CPT is a registered trademark of the American Medical Association.
AMA Disclaimer
2
• Be alert to confusion over term “HCPCS”
• Understand the variety of goods and services that can be reported with HCPCS Level II codes
• Review concepts on when HCPCS Level II codes are appropriate
• See importance of teaching HCPCS to your students
Goals
• Healthcare Common Procedural Coding System
– This designation comes from CMS, and
encompasses:
• HCPCS Level I, national CPT® codes
• HCPCS Level II, supplemental codes for supplies and
procedures
• HCPCS Level III, defunct local coding system
HCPCS
3
• Before pursuing a HCPCS Level II code, ask, “Is
this a routine supply?”
– Routine supply is not reported
– Nonroutine supply is reported
• Also ask, “Is the place of service appropriate for
HCPCS Level II code reporting?”
HCPCS – Level II
• HCPCS Level II created by CMS
– But that doesn’t mean all codes are covered
• Some are never covered, by statutory law
• Some coverage is determined locally
HCPCS – Level II
4
• Alpha-numeric
• Report supplies as well as, services not included in CPT®
• New HCPCS codes are evaluated in public hearings held in Baltimore