Understanding HCPCS

HCPCS stands for Healthcare Common Procedural Coding System

There are 2 levels associated with HCPC coding system, level I is found using the CPT manual and level II is found in the HCPCS manual

HCPCS are used to bill products, supplies, and services that are not found in the CPT manual.

Examples of what is found in HCPCS

  • Ambulance services
  • DME
  • Prosthetics
  • Orthotics
  • Supplies
    • Tubes
    • Syringes
    • Monitoring equipment
    • Gauze
    • Bandages
    • Splints
    • And more
  • Drugs

HCPCS are alphanumeric codes

  • Ambulance codes and medical/surgical supplies
  • Enteral and parenteral therapy
  • Outpatient PPS
  • Dental
  • Durable Medical Equipment
  • None
  • Procedures and professional services
  • Alcohol and drug abuse treatment
  • None
  • Drugs administered other than by oral route
  • Durable Medical Equipment- MACS
  • Orthotic procedures and services
  • Medical Services
  • None
  • Pathology and laboratory services
  • Temporary codes
  • Radiology services
  • Temporary national codes
  • National codes established for state Medicaid agencies
  • None
  • Vision services

HCPCS also has a variety of modifiers that need to be noticed for such circumstances like anatomical location, anesthesia services, and other services these modifiers can be used with HCPCS and CPT codes. Make sure you do not miss these as you are submitting procedural and service codes.

Happy Coding

Danielle

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