seminar 5. hcpcs healthcare common procedure coding system level i codes are cpt codes (for...

Seminar 5

HCPCS Healthcare Common Procedure Coding

System Level I codes are CPT codes (for

procedures) Level II codes are HCPCS codes (for

durable medical equipment, ambulance transportation, insulin, etc.---things not covered by CPT codes)

HCPCS codes were created in the 1980s Codes are five characters in length Begin with alpha A-V followed by four

numbers When people refer to HCPCS codes, they

are most likely referring to the level II codes

HCPCS level II codes are organized according to the type depending on the purpose of the codes and the entity responsible for establishing and maintaining them. The five types are:

Permanent national codes Dental codes Miscellaneous codes Temporary codes Modifiers

HCPCS modifiers Attached to any HCPCS level I (CPT) or

level II (HCPCS) code to provide additional information regarding the product or service reported

Adds another level of detail to an item or service

A patient was supplied with an air pressure mattress. Report the HCPCS code:

a.E0181b.E0184c.E0185d.E0186

A patient was supplied with an air pressure mattress. Report the HCPCS code:

a.E0181b.E0184c.E0185

d.E0186

Magnetic resonance imaging without contrast followed by with contrast, left breast.

a.C8903-LTb.C8904-LTc.C8905-LTd.C8908-LT

Magnetic resonance imaging without contrast followed by with contrast, left breast.

a.C8903-LTb.C8904-LT

c.C8905-LTd.C8908-LT

A patient received an injection of hydrocortisone acetate, 15mg, for contact dermatitis.

a.J1700b.J1700, J1700c.J1720d.J1720, J1720

A patient received an injection of hydrocortisone acetate, 15mg, for contact dermatitis.

a.J1700b.J1700, J1700c.J1720d.J1720, J1720

A patient required catheterization for the collection of a specimen.

a.A4300b.A4305c.P9612d.P9615

A patient required catheterization for the collection of a specimen.

a.A4300b.A4305

c.P9612d.P9615

A patient received 2 mg leuprolide acetate for treatment of prostate cancer.

a.J1950b.J9217c.J9218, J9218d.J9219

A patient received 2 mg leuprolide acetate for treatment of prostate cancer.

a.J1950b.J9217c.J9218, J9218d.J9219

A patient in a drug and alcohol rehabilitation hospital received an injection of methadone by the treating physician

a.H0020b.H0029c.H0033d.J1230

A patient in a drug and alcohol rehabilitation hospital received an injection of methadone by the treating physician

a.H0020b.H0029c.H0033d.J1230

An 8 year-old boy is fitted with a long-arm cast. Service is performed in part by a resident under the direction of a teaching physician.

a.Q4007b.Q4007-GCc.Q4008-GCd.Q40010

An 8 year-old boy is fitted with a long-arm cast. Service is performed in part by a resident under the direction of a teaching physician.

a.Q4007b.Q4007-GCc.Q4008-GCd.Q40010

The patient’s family received 30 minutes of family training and counseling, which was provided for the purpose of child development.

a.T1025b.T1026c.T1027d.T1027, T1027

The patient’s family received 30 minutes of family training and counseling, which was provided for the purpose of child development.

a.T1025b.T1026c.T1027

d.T1027, T1027

A patient received a hand-held low vision aid.

a.V2020b.V2510c.V2600d.V2610

A patient received a hand-held low vision aid.

a.V2020b.V2510

c.V2600d.V2610

Modifiers

What is the HCPCS modifier AH?

What is the HCPCS modifier AH?

Clinical psychologist

What is the HCPCS modifier TA?

What is the HCPCS modifier TA?

Left foot, great toe

What is the HCPCS modifier SB?

What is the HCPCS modifier SB?

Nurse midwife

What is the HCPCS modifier E4?

What is the HCPCS modifier E4? Lower right eyelid

What is the HCPCS modifier FA?

What is the HCPCS modifier FA? Left hand, thumb

What is the HCPCS modifier NU?

What is the HCPCS modifier NU? New equipment

What is the HCPCS modifier RC?

What is the HCPCS modifier RC? Right coronary artery

What is the HCPCS modifier TC?

What is the HCPCS modifier TC? Technical component

What is the HCPCS modifier TD?

What is the HCPCS modifier TD? Registered nurse

What is the HCPCS modifier UQ?

What is the HCPCS modifier UQ? Four patients served

Drugs are listed in the HCPCS Table of Drugs according to:

a.Dosage to be usedb.Generic or chemical namec.Route of administrationd.Trade or brand name

Drugs are listed in the HCPCS Table of Drugs according to:

a.Dosage to be usedb.Generic or chemical namec.Route of administrationd.Trade or brand name

Mr. William Hansberry attended a local clinic’s administration of influenza vaccine at a local shopping mall. Mr. Hansberry asks that the clinic bill Medicare for the shot.

a. G0001b.G0008c. G0009d.G0010

Mr. William Hansberry attended a local clinic’s administration of influenza vaccine at a local shopping mall. Mr. Hansberry asks that the clinic bill Medicare for the shot.

a. G0001

b.G0008c. G0009d.G0010

Michael Lincoln presents to the dental clinic for a fluoride treatment. Michael has several cavities, and he is only 7 years of age.

a. D1110b.D1120c. D1203d.D1206

Michael Lincoln presents to the dental clinic for a fluoride treatment. Michael has several cavities, and he is only 7 years of age.

a. D1110b.D1120c. D1203

d.D1206

A 75 year old terminal lung cancer patient is admitted to hospice care for general inpatient care

a. T2042b.T2043c. T2044d.T2045

A 75 year old terminal lung cancer patient is admitted to hospice care for general inpatient care

a. T2042b.T2043c. T2044

d.T2045

Injection of Depo-Provera, 50 milligramsa. J1051b. J1055c. J1056d. J1060

Injection of Depo-Provera, 50 milligrams

a.J1051b. J1055c. J1056d. J1060

Questions???