Healthcare Common Procedural Coding System (HCPCS)

Description: The Healthcare Common Procedural Coding System (HCPCS) is
a set of standards created in 1978[1] that are designed to process
patient insurance claims. Although initially voluntary[1], HIPPA made
madatory the use HCPCS. Medicare, Medicaid, and various other
insurance programs follow HCPCS codes. The HCPCS consists primarly of
two main groupings - Level I and Level II codes. Level III ("local")
codes were first established when an insurer preferred that suppliers use a local code to identify a service, which at the time level I and level II codes could not satify the request. Due to the unreliability of local codes they were officially removed on December
31, 2003[1].
Level I
-Contains CPT (Current Procedural Terminology),
-a system maintained by the American Medical Association[2] compromised of
numerical codes
-CPT codes consist of five numbers.
-These codes are used to identify medical services and procedures by physicians and other health care professionals.[3]
-Once the service has been identified the health care professionals use the CPT codes for billing private or private health insurance programs. [3]

Level II
-The use of level II of the HCPCS begain in the 1980's
-Contains codes which identify products,
such as:
-Supplies, services and equipment
-These codes are not included in the CPT and consist of a single letter
followed by four numbers.

Examples of HCPCS Codes

Basic metabolic panel (Calcium, ionized)

Cystatin C

Calprotectin, fecal

Gonadotropin, chorionic (hCG); free beta chain

Mononuclear cell antigen, quantitative (eg, flow cytometry), not
otherwise specified, each antigen

Web Resources: MedHCPCSGenInfo/ provider/viewarticle.aspx? articleid=5790 Healthcare_Common_Procedure_ Coding_System

Related Terminology:
AMA (American Medical Association)
CPT (Current Procedural Terminology)

[1] wiki/Healthcare_Common_ Procedure_Coding_System
[2] MedHCPCSGenInfo/
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