HCPCS Codes and CPT or PT codes are commonly used for billing Medicare and other insurance companies.
- HCPCS = The Healthcare Common Procedure Coding System is based on the American Medical Association’s Current Procedural Terminology (CPT). Used for reporting physician services for Medicare. Commonly pronounced “Hix-Pix” or “Hicks-picks”.
- HCPCS = A set of codes used by Medicare that describes services and procedures. HCPCS includes Current Procedural Terminology (CPT) codes for services not included in the normal CPT code list, such as durable medical equipment and ambulance service. While HCPCS is nationally defined, there is a provision for local use of certain codes.
- Although there is a provision for local use of certain codes it is rarely used.
- The Health Care 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 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. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) made the HCPCS mandatory for Medicare and Medicaid billings.
- 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. [1]
- Level III consists of local codes for state Medicaid agencies.
PalmettoGBA.com has some great tools for searching for codes, pricing and date of service; *SEE/CLICK On-line Coding Assistance*
Note: LG does not warrant the appropriateness of reimbursement codes. The provider is solely responsible for billing under the reinbursement code.