HEALTHCARE COMMON PROCEDURAL CODING SYSTEM

Procedure Modifier Codes can be used with all three levels, with the WA - ZY range used for locally assigned procedure modifiers A medical code set that identifies health care procedures, equipment, and supplies for claim submission purposes. It has been selected for use in the HIPAA transactions. HCPCS Level I contains numeric CPT codes which are maintained by the AMA. HCPCS Level II contains alphanumeric codes used to identify various items and services that are not included in the CPT medical code set. These are maintained by HCFA, the BCBSA, and the HIAA. HCPCS Level III contains alphanumeric codes that are assigned by Medicaid state agencies to identify additional items and services not included in levels I or II. These are usually called "local codes", and must have "W", "X", "Y", or "Z" in the first position. HCPCS

Healthcare Common Procedure Coding System (HCPCS) Code Set

The Healthcare Common Procedure Coding System (HCPCS) is a set of health care procedure codes based on the American Medical Association's Current Procedural Terminology (CPT). Commonly pronounced Hick-Picks. The Healthcare Common Procedure Coding System (HCPCS) was established in 1978 to provide a standardized coding system for describing the specific items and services provided in the delivery of health care. Such coding is necessary for Medicare, Medicaid, and other health insurance programs to ensure that insurance claims are processed in an orderly and consistent manner. Initially, use of the codes was voluntary, but with the implementation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) use of the HCPCS for transactions involving health care information became mandatory. HCPCS includes three levels of codes: Level I consists of the American Medical Association's Current Procedural Terminology (CPT) and is numeric. Level II codes are alphanumeric and primarily include non-physician services such as ambulance services and prosthetic devices, and represent items and supplies and non-

physician services not covered by CPT-4 codes (Level I). Level II alphanumeric procedure and modifier codes are a single alphabetical letter followed by 4 numeric digits; the first alphabetic letter is in the A to V range. Level II codes are maintained by the US Centers for Medicare and Medicaid Services (CMS). There is some overlap between HCPCS codes and National Drug Code (NDC) codes, with a subset of NDC codes also in HCPCS, and vice-versa. The CMS maintains a crosswalk from NDC to HCPCS in the form of an Excel file. The crosswalk is updated monthly. Level III codes, also called local codes, were developed by state Medicaid agencies, Medicare contractors, and private insurers for use in specific programs and jurisdictions. The use of Level III codes was discontinued on December 31, 2003, in order to adhere to consistent coding standards. The acronym HCPCS originally stood for HCFA Common Procedure Coding System, as the Centers for Medicare and Medicaid (CMS) was previously (before 2001) known as the Health Care Financing Administration (HCFA).

Professional Coding: Part Three - HCPCS 7/30/2001 Robert C. Fifer, Ph.D., Director of Audiology and Speech-Language Pathology, Mailman Center for Child Development, University of Miami, School of Medicine, Miami, Florida

This article is the third in a special series on coding. Parts one (September, 2000) and two (December, 2000) are available online via AudiologyOnline, in the 'Article Archives.' HCPCS

In the first two parts of this series, I presented the more common aspects of procedural coding, the use of CPT codes to describe what you did and the use of ICD-9 codes to describe what you found. In this article I will describe another coding system, designed to complement CPT codes. HCPCS (HCFA Common Procedural Coding System) is a series of codes developed by the federal government and specifically the Center for Medicare and Medicaid Services (CMS) (formerly known as the Health Care Finance Administration (HCFA)). CMS uses these codes primarily for Medicare and Medicaid to describe procedures or items not listed in the CPT manual. 'What is the difference between CPT codes and HCPCS?' CPT codes are owned and copyrighted by the American Medical Association. They describe common procedures used in the course of health care delivery and are oriented to physician use in one way or another. HCPCS are codes generated by the federal government to describe procedures that have special significance to either the Medicaid or Medicare programs. There is some overlap between CPT codes and HCPCS. This is because