Health care insurers process over 5 billion claims every year. HCPCS codes were developed to help ensure that claims could be processed in a consistent and simplified way. HCPCS codes are divided into three subsystems: level I, level II and level III, each designated for a specific purpose.
HCPCS Codes - Level I
Level I HCPCS codes are made up of CPT-4 codes (a numeric coding system devised by the American Medical Association). Health care professionals use this notation to identify services and procedures, for which they bill insurance programs. Level I HCPCS codes consist of 5 numeric digits.
HCPCS Codes - Level II
Level II HCPCS codes identify products, supplies, materials and services which are not included in the CPT-4 code, such as ambulance services, prosthetics, medical equipment and supplies (DMEPOS) when used outside a medical office. Level II HCPCS codes are also called alpha-numeric codes because they consist of one letter followed by 4 numeric digits.
HCPCS - Level III
Level III HCPCS codes are developed by Medicaid State Agencies, Medicare contractors and private insurers for use in specific programs and jusrisdictions. HCPCS Level III codes are also called local codes. These codes allow insurers to electronically process claims for new services for which a level I or level II code has not yet been established.
National Permanent Level II HCPCS Codes
National Permanent Level II HCPCS Codes are maintained by the HCPCS National Panel, a group comprised of representatives from the Blue Cross/Blue Sheild Association (BCBSA), the Health Insurance Association of America (HIAA), and CMS. Permanent Level II HCPCS Codes provide a standardized coding system that is managed jointly by public and private insurers, thus providing a stable system for claims processing. These codes can be used by all private and public insurers.
Temporary Level II HCPCS codes
Temporary Level II HCPCS codes make up 35% of all level II codes. These codes help insurers meet operational needs which are not met with existing codes. In the case of Medicare, the HCPCS workgroup makes decisions regarding temporary HCPCS codes. Even though temporary HCPCS codes are established to meet the needs of a particular insurer, they can also be used by other insurers. These codes can remain "temporary" indefinitely.
Types of Temporary HCPCS codes
C codes
Identify idems that may qualify fdor "pass through" payments under the hospital outpatient prospective payment system (HOPPS)
G codes
Identify professional health care procedures and services that would be coded as CPT-4, but for which no CPT-4 code exists.
Q codes
Identify services that would not be given a CPT-4 code such as drugs, biologicals, and other medical equipment or services.
K Codes
Used by DMERCs in situations when the national permanent HCPCS level II codes do not include codes needed to implement a DMERC medical review policy.
S Codes
Used by the BCBSA and the HIAA to report drugs and services for which there are no national permanent Level II HCPCS codes.
H Codes
Used by state Medicaid agencies to identify mental health services.
T Codes
Used by state Medicaid agencies for Medicaid Program administration.
Good Luck on your presentation!
2007-01-02 16:24:04
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answer #1
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answered by steffers4979 4
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HCPCS codes are what they use to ensure that Medicare and other health insurance programs claims are processed in an orderly and consistent manner.
They are the standardized codes that are used to categorize these claims. There are both Level I and Level II code sets. Level I of the HCPCS is comprised of CPT (Current Procedural Terminology), a numeric coding system maintained by the American Medical Association. These codes are used primarily to identify medical services and procedures furnished by physicians and other health care professionals.
Level II codes are used primarily to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician's office.
Level III (or "local") codes were eliminated after December 2003.
2007-01-02 16:26:28
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answer #2
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answered by fairygothmommy 2
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The Health care Common Procedure Coding System, is a system of codes used to identify medical procedures and services. It is used mainly for billing purposes.
There are 2 levels, level 1 mainly for procedures and services provided by physicians and level 2 for equipment supplies and some other services not included in level 1.
2007-01-02 16:28:05
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answer #3
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answered by Stewart H 4
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HCPCS code G0337 “Hospice Pre-Election Evaluation and Counseling Services,” will be used to designate that these services have been provided. Hospice agencies will bill their Regional Home Health Intermediary, using the designated G0337 code for specified services provided by a physician who is either the medical director of or employee of the hospice agency.
2016-03-16 05:52:40
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answer #4
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answered by Anonymous
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these codes are used when billing a medical claim. each code has a discription that is nationally know. for example z8975
may be the code for anER visit at a hospital
2007-01-02 16:24:09
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answer #5
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answered by Hello Kitty 1
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