HCPCS : Health Care Financing Administration common procedure coding system, national level II Medicare codes PDF
Preview HCPCS : Health Care Financing Administration common procedure coding system, national level II Medicare codes
H'C'P'C'S Millennium Edition Health Care Financing Administration Common Procedure Coding System ^ National Level II Medicare Codes Color Coded 2001 rsns M. OTHER TITLES OF INTEREST CODING AND REIMBURSEMENT Codelink® CPT & ICD-9-CM Code Linkage Series Collections Made Easy! CPT & HCPCS Coding Made Easy! E/M Coding Made Easy! 4'in-l Master Coder Series HCPCS Coders Choice®, Color Coded, Thumb Indexed Health Insurance Carrier Directory ICD-9-CM, Coders Choice®, Thumb Indexed ICD-9-CM, TimeSaver®, Ring Binder, Tab Indexed ICD-9-CM Coding For Physicians' Offices ICD-9-CM Coding Made Easy! 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All rights reserved. None of the content of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means (electronic, mechanical, photocopying, recording or otherwise) without the prior written permission of the publisher. Additional copies of this book may be purchased from any medical book store, from PMIC by mail to the above address, by visiting our web site at http://www.medicalbookstore.com, or by calling 1-800-MED-SHOP. FOREWORD ( The HCFACommon Procedure Coding System (HCPCS), National Level II, is a listing of codes and descriptive terminology used for reporting the provision of supplies, materials, injections and certain services and procedures to Medicare. HCPCS 2001 is the most recent revision of the HCPCS National Level II codes. The changes that appear in this revision have been prepared by our editorial staff using the November 2000 HCPCS revisions released by the Health Care Financing Administration. HCPCS National Level II codes are now effective January 1st of each year. Even though HCPCS National Level II codes have been in use since 1983, there is still some confusion among health care professionals regarding when and how to use these codes instead of the more familiar CPT codes. In addition, due to what is known as "carrier discretion," the use, interpretation, and reimbursement pohcies for HCPCS National Level II codes, which should be uniform nationwide, vary from carrier to carrier. Add to this a third coding system, known as HCPCS Local Level III, and the confusion becomes more understandable. Unfortunately, many health care professionals deal with the confusion by ignoring this coding system, to the serious detriment of their reimbursement. One of our goals as a pubhsher is to educate our customers about the business of medicine. One of our most successful methods of accomplishing this goal is to create publications about new or unfamiliar concepts, such as HCPCS, that are similar in format and content to related publications, such as CPT. This provides our customers with an opportunity to learn and implement new concepts of vital importance to their medical practice using formats, conventions and terminology that they already use and understand. James B. Davis, President ui DISCLAIMER This publication is designed to offer basic information regarding coding and billing of medical services, supplies and procedures using the HCPCS coding system. The information presented is based upon material obtained from the Health Care Financing Administration and the experience and interpretations of the editors and publisher. Though all of the information has been carefully researched and checked for accuracy and completeness, the publisher accepts no responsibihty or hability with regard to errors, omissions, misuse or misinterpretation. IV CONTENTS ( INTRODUCTION vii Structure of HCPCS vii Sections viii Instructions for Use of HCPCS ix Format of the Terminology ix Guidelines x HCPCS Modifiers x Unlisted Procedure or Service xi Special Report xii HCPCS Code Changes xii Special Coverage Symbols xiii Durable Medical Equipment Regional Carriers (DMERCs) xiv .. HCPCS on Disk xvi TRANSPORTATION SERVICES 1 CHIROPRACTIC SERVICES 9 MEDICAL AND SURGICAL SUPPLIES 11 ADMINISTRATIVE, MISCELLANEOUS AND INVESTIGATIONAL 35 ENTERAL AND PARENTERAL THERAPY 37 HOSPITAL OUTPATIENT PPS CODES 41 DENTAL PROCEDURES 83 DURABLE MEDICAL EQUIPMENT (DME) 115 G CODES FOR PROCEDURES 141 REHABILITATIVE SERVICES 153 CONTENTS DRUGS ADMINISTERED OTHER THAN ORAL METHOD 157 CHEMOTHERAPY DRUGS 181 K CODES: FOR DMERCS USE ONLY 187 ORTHOTIC PROCEDURES 207 PROSTHETIC PROCEDURES 237 MEDICAL SERVICES 265 PATHOLOGY AND LABORATORY 269 TEMPORARY CODES 273 DIAGNOSTIC RADIOLOGY SERVICES 283 PRTVATE PAYER CODES 285 VISION SERVICES 297 HEARING SERVICES 307 — APPENDIX A MODIFIERS 311 — APPENDIX B SUMMARY OF ADDITION CHANGES AND REVISIONS 323 — APPENDIX C TABLE OF DRUGS 445 INDEX 505 VI
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