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Topic: Health Care Procedure Coding System

	Health Care Procedure Coding System - Wikipedia, the free encyclopedia
		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).
		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.
	en.wikipedia.org /wiki/HCPCS (153 words)

	Coding for Reimbursement / Health Care Financing Administration (Site not responding. Last check: 2007-10-22)
		Local codes, published ad hoc, are developed by statewide insurance carriers and cover local trends in health care that are not covered in the CPT or national code.
		The CPT code is five digits with the first number of the code dependent on the type of procedure.
		The national codes begin with a letter from A to V, while the local codes begin with W to Z (Gerchufsky, 1996).
	www.pittstate.edu /artsc/reimbursementcoding.htm (545 words)

	[No title] (Site not responding. Last check: 2007-10-22)
		For Medicare and other health insurance programs to ensure that these claims are processed in an orderly and consistent manner, standardized coding systems are essential.
		The CPT is a uniform coding system consisting of descriptive terms and identifying codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals.
		The elimination of local codes was postponed, as a result of section 532(a) of BIPA, which continued the use of local codes through December 31, 2003.
	cms.hhs.gov /medicare/hcpcs/default.asp (578 words)

	HCFA'S New ICD-10 Procedure Coding System
		When the procedure has two imaging sessions performed at different times, but not an additional administration of a radiopharmaceutical, the two imaging procedures are noted in the qualifier column (character 7).
		The potential for the system to result in invalid data bases by, for example, allowing coders to assign what appears to be legitimate codes to procedures that do not actually exist.
		The system disallows the usage of many terms commonly used in clinical practice, for example, it appears that the commonly used term hysterectomy would be called a "resection of the uterus" under the new system.
	interactive.snm.org /index.cfm?PageID=381&RPID=277 (926 words)

	HCPCS Procedure Codes
		Health Care Common Procedure Coding System (HCPPS) codes consist of codes from CPT as well as Level II national codes.
		With the exception of temporary codes, Level II alphanumeric procedure and modifier codes are updated annually on January 1.
		CDT codes are also included in alpha-numeric HCPCS with a first character of D. Codes are revised on a five-year cycle by the ADA through its Council on Dental Benefits Program.
	www.medicalcodingandbilling.com /more_codes.htm (497 words)

	March 2005 Part B Medicare Bulletin (Site not responding. Last check: 2007-10-22)
		Codes G0345 and G0346 are intended to report a hydration IV infusion consisting of a prepackaged fluid and/or electrolyte solutions (e.g., normal saline, D5-1/2 normal saline +30mEq KC1/liter), but are not used to report infusion of drugs or other substances.
		CPT codes 96420, 96422, 96423, and 96425 are recognized for Medicare purposes in 2005.
		CPT codes 96440, 96445, 96450, and 96520 are recognized for Medicare purposes in 2005.
	www.cignamedicare.com /partb/bltin/all/05bltin/05_03/base_March03.html (7909 words)

	As Easy as A-B-C. Acupuncture Today, April 2003
		The codes provide representations of alternative medicine, nursing and other integrative health care practices, and consist of a five alphabetic character field, followed by an optional two-character alphanumeric modifier.
		The ABC codes are designed to fill these gaps on several levels, including the CPT codes and other areas of the HCPCS, by describing certain integrative health care practices and practitioners more accurately.
		Implementation of the codes would add a variety of therapies that acupuncturists, herbalists and doctors of Oriental medicine perform to the existing coding system; in fact, an entire section of the ABC codes is devoted to "herbs and natural substances," which comprise a large part of the practice of traditional Chinese medicine.
	www.acupuncturetoday.com /archives2003/apr/04abccodes.html (1191 words)

	PRESS RELEASE AHA and CMS Establish Clearinghouse to Enhance Understanding of Health Care Common Procedure Coding System (Site not responding. Last check: 2007-10-22)
		HCPCS is a national standard code set used by health care practitioners, providers and suppliers throughout the United States when filing insurance claims for drugs, medical devices and other items and services.
		The AHA is a not-for-profit association of health care provider organizations and individuals committed to the improvement of health in their communities.
		Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends.
	www.marketwire.com /mw/release_html_b1?release_id=108194 (471 words)

	Office Systems Program at Kishwaukee College: Medical Billing & Coding (Site not responding. Last check: 2007-10-22)
		A: Health care in America is an explosive industry.
		Four million jobs will open up in the next ten years in the health care industry, and many of those positions will be outside the care-giving arena specifically, such as consulting firms and claims-review/auditing firms.
		The Handbook classifies coders as “medical records and health information technicians.” Of significance is the projected growth of this career; it is considered “one of the fastest growing occupations.
	kish.cc.il.us /programs_of_study/office_systems/medical_billing-coding.shtml (682 words)

	Billing and Reimbursement Manual
		Level I is used for reporting medical services and procedures; Level II is used for reporting durable medical equipment, dental vision and other services; and Level III is used for reporting services specific to Ohio workers’ compensation.
		Under the Ohio Administrative Code, providers that belong to a MCO provider panel are reimbursed at the lesser of their billed charges, the BWC fee schedule amount, or the MCO panel amount.
		Payment is a broad term applied to all medical reimbursement issued by BWC and the managed care organizations, as well as to all compensation BWC issues to injured workers with lost-time claims.
	www.ohiobwc.com /basics/guidedtour/generalinfo/ProvGlossBRM.asp (848 words)

	HIPAA Links
		Administrative Simplification requires that health plans, health care clearinghouses use certain standard transaction formats and code sets for the electronic transmission of health information.
		Health care providers that transmit any health information in electronic form in connection with a transaction covered in the rules are also required to use the standard transactions and codes sets for the electronic transmission of health information.
		ASCA allows the implementation date of the Transaction and Code Sets Rule to be extended from October 16, 2002 to October 16, 2003.
	hipaa.ohio.gov /hipaalinks.htm (800 words)

	OMAP - Medical Assistance Bulletin
		The procedure codes end dated on the fee schedule as a result of those updates will be noncompensable for services provided after August 31, 2004.
		The fee changes for these four codes and the addition of procedure code G0234 are effective July 1, 2004.
		Due to the time lapse between the implementation date of the HCPCS procedure codes and the date of this bulletin, providers will be permitted to submit claims exceeding 180 days from the date of service when billing with the new codes.
	www.dpw.state.pa.us /omap/provinf/mabull/990409.asp (641 words)

	Department of Mental Health - Office of HIPAA Compliance (Site not responding. Last check: 2007-10-22)
		If the service functions change to procedure codes include different types of service, new rate studies would have to be conducted.
		These codes are mapped to procedure codes for billing insurance and Medicare, modes and service functions for SD/MC, and other categories for internal reporting.
		Counties would use a code map for reporting the service functions to CSI, use the service functions for the cost report, and map to CMS procedure codes for Medi-Cal.
	www.dmh.ca.gov /hipaa/faqs.asp (1384 words)

	[No title]
		The applicable HCPCS codes (17304, 17305, 17306, 17307, and 17310) include the physician microscopic exam and interpretation, which are characterized as high complexity tests under the Clinical Laboratory Improvement Amendments (CLIA).
		The HCPCS codes for Mohs micrographic surgery [i.e., 17304, 17305, 17306, 17307, and 17310] require a physician to act as both a surgeon and a pathologist.
		A facility without a valid current CLIA certificate, with a current CLIA certificate of waiver (certificate type code 2), or with a current CLIA certificate for provider-performed microscopy procedures (certificate type code 4) will not be permitted to bill for these tests.
	www.arkmedicare.com /provider/viewarticle.aspx?articleid=1389 (723 words)

	Health Care Procedure Coding System (HCPCS) Modifiers
		To avoid rejections, use the code that is on the approval letter when submitting claims for non-emergency transportation services.
		It is the responsibility of each provider to ensure that all materials related to changes in the department’s billing procedures, handbooks, etc., are shared with their software vendor, corporate help desk or information systems area.
		Questions regarding this notice may be directed to the Bureau of Comprehensive Health Services toll-free at 1-877-782-5565 or 217-782-5565.
	www.hfs.illinois.gov /transportation/102204hcpcs.html (239 words)

	American Republic News
		Claim Status Category codes are used in the Health Care Claim Status Notification (277) transaction in the STC01-1, STC10-1 and STC11-1 composite elements.
		Claim Status codes are used in the Health Care Claim Status Notification (277) transaction in the STC01-2, STC10-2 and STC11-2 composite elements.
		Although Taxonomy Codes are not required in the 4010A1, American Republic’s preference is that they be included in the 837 transmissions.
	www.aric.com /News.aspx?catid=HIPAA&articleid=37 (525 words)

	NHIA Releases National Coding Standard for Home Infusion Claims Under HIPAA
		Under the Health Insurance Portability and Accountability Act (HIPAA), beginning as early as October 16, 2002, health care payers and providers must use only standard medical code sets and make standard electronic transactions available for health insurance transactions.
		Starting for use on January 1, 2002, the Centers for Medicare and Medicaid Services (CMS) included in its HCPCS (Health Care Common Procedure Coding System) a comprehensive set of "per diem" codes that will be used by most commercial and some government payers to process home infusion claims.
		The standard was developed in response to many requests for guidance from payers, providers, information system and reimbursement specialists, and claims clearinghouses regarding how to implement the "per diem" coding system.
	www.nhianet.org /natlcodingstd.htm (557 words)

	Online Education - Medical Coding: Definitions & Distinctions - How To Guide
		This course is an introduction to basic coding definitions and distinctions between and about the International Classification of Diseases, Ninth Revision, Clinical Modification System (ICD9-CM); the Current Procedural Terminology, Fourth Edition (CPT4); Health Care Procedure Coding System (HCPCS); Diagnostic and Statistical Manual of Mental Disorders; Fourth Edition (DSM-IV) and the upcoming ICD10.
		This course is an introduction to basic coding definitions and distinctions between and about the International Classification of Diseases, Ninth Revision, Clinical Modification System (ICD9-CM); the Current Procedural Terminology (CPT); Health Care Procedure Coding System (HCPCS); Diagnostic and Statistical Manual of Mental Disorders; Fourth Edition (DSM-IV) and the upcoming ICD10.
		This medical coding course is designed mostly for students wanting practice in ICD-9-CM inpatient hospital coding with respect to to linking, combining and applying different types of coding for ICD-9-CM, Volumes 1, 2 and Procedures...
	search.universalclass.com /i/search/2765.htm (1648 words)

	Ambulance Fee Schedule-Final Rule (Site not responding. Last check: 2007-10-22)
		Specialty Care Transport (SCT)--When medically necessary, for a critically injured or ill beneficiary, a level of interhospital service furnished beyond the scope of the paramedic as defined in the National EMS Education and Practice Blueprint.
		Specialty Care Transport (SCT)--In the proposed rule, we stated that this level of service is defined by, when medically necessary, for a critically injured or ill beneficiary, a level of interhospital service furnished beyond the scope of the paramedic as defined in the National EMS Education and Practice Blueprint.
		Comment: Some commenters asked whether the code for the SCT level service may be used as a code for a trip from a facility to an air ambulance and from the air ambulance to the final facility destination.
	www.pwwemslaw.com /ACTIVE/Feeschedule/FeeScheduleFinalRule.htm (8662 words)

	HSS Insider Information - Library (Site not responding. Last check: 2007-10-22)
		The National Center for Health Statistics (NCHS) coordinates ongoing updates to the ICD-9-CM diagnosis classification (Volumes 1 and 2 of ICD-9-CM), which occur each October (and possibly in April).
		Although implementation is still several years away, it is never too soon to become educated on these new classification systems and to begin preparing for the transition.
		HCPCS Level II Level II of the Health care Common Procedure Coding System (HCPCS) is the HIPAA-approved code set for reporting products, supplies, and services not included in the CPT-4 (HCPCS Level I) codes.
	www.hssweb.com /Insider_Information/Coding.aspx (311 words)

	Apria - resources - News (Site not responding. Last check: 2007-10-22)
		Revise the HCPCS code application form to be more streamlined and incorporate suggestions CMS received from a stakeholder survey.
		The first change will occur with the coding application deadline, pushed up from April 1 to Jan. 3, 2005 to "permit expanded opportunities for public comment on preliminary coding decisions," according to a CMS press release.
		The changes are among the first actions taken by CMS' new Council on Technology and Innovation, which was established under MMA to coordinate activities of coverage, coding and payment processes affecting new technologies and procedures.
	www.apria.com /resources/1,2725,494-230718,00.html (347 words)

	Medical Coding at BCHS
		Medical coders are an important part of the health care workforce and are employed in physician offices, clinics, hospitals, and insurance firms.
		These codes are determined in compliance with several commonly used references including the International Classification of Diseases, 9th Revision, Clinical Modification System (ICD9-CM), Current Procedural Terminology, 4th Edition (CPT4), and Health Care Procedure Coding System (HCPCS).
		By accessing this site, you acknowledge and agree that your use of this site shall be governed by, interpreted, and enforced in accordance with the laws of the State of Tennessee, irrespective of the state in which you are physically located at the time of use.
	www.bchs.edu /mc.asp (259 words)

	[No title] (Site not responding. Last check: 2007-10-22)
		\par {\\bkmkstart cp15}{\\bkmkend cp14}4.2.2.3.\~ Establish policies and procedures for the control and retention of medical records.
		\par {\\bkmkstart cp16}{\\bkmkend cp15}4.2.2.4.\~ Effectiveness in meeting coding accuracy standards should be considered in military and civilian performance reports.
		\par {\\bkmkstart cp26}{\\bkmkend cp25}4.3.3.\~ 100 percent of inpatient records should be coded within 30 days after discharge.
	www.dtic.mil /whs/directives/corres/rtf/d604041x.rtf (477 words)

	Hospital and Ambulatory Surgical Center Section 14 (NCIC Medical Fee Schedule Updates)
		Medical services billed on a CMS (HCFA) 1500 are reduced according to the fee established in the Medical Fee Schedule for the current procedural terminology (“CPT”) codes and the Health Care Procedure Coding System (HCPCS) codes.
		If a Health Care Procedure Coding System (HCPCS) code is billed on the CMS (HCFA) 1500, and does not have a fee assigned in the Medical Fee Schedule, the provider is entitled to 20% above invoice cost for the Health Care Procedure Coding System (HCPCS) code only.
		The Commission’s procedures identify 964 as one of the revenue codes that should be billed on the HCFA 1500.
	www.comp.state.nc.us /ncic/pages/feesec14.htm (2214 words)

	Current Procedural Terminology - Wikipedia, the free encyclopedia
		The Current Procedural Terminology is the list maintained by the American Medical Association to provide unique billing codes for services rendered.
		It currently is used as Level 1 of the Health Care Procedure Coding System.
		This page was last modified 12:57, 7 July 2006.
	en.wikipedia.org /wiki/Current_Procedural_Terminology (75 words)

	Rural Assistance Center :: News Details
		AHA and CMS Establish Clearinghouse to Enhance Understanding of Health Care Common Procedure Coding System
		Supporting the AHA clearinghouse will be an Editorial Advisory Board (EAB) for Coding Clinic for HCPCS, which is a voluntary board that includes CMS and other stakeholders in the health care community.
		The HCPCS was established in 1978 by CMS to provide a standardized coding system for describing the specific items and services provided in the delivery of health care. Medicare, Medicaid and other health insurance programs use HCPCS to ensure that insurance claims are processed in an orderly and consistent manner.
	www.raconline.org /news/news_details.php?news_id=3765 (117 words)

	New HCPCS Codes and System Edits for Supplies and Accessories for Ventricular Assist Devices
		This instruction and related CR 3761 announce new Health Care Common Procedure Coding System (HCPCS) codes and implement related Medicare system edits for replacement accessories and supplies for implanted Ventricular Assist Devices (VADs) that are covered under the prosthetic device benefit in section 1834(h) of the Social Security Act.
		This instruction and related CR 3761 provides the new codes that are being added to HCPCS edits for replacement accessories and supplies for (VADs), effective October 1, 2005.
		Suppliers and hospitals are required to add HCPCS modifier “RP” (replacement and repair) to the claim with codes Q0480 thru Q0499 and Q0501 thru Q0504, in those instances where replacement is needed before the lifetime of the item has expired.
	www.mutualmedicare.com /news/20050513_03.html (726 words)

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