HCSPCS level I and Level II codes & relation to CPT.
In general terms — with some exceptions — medical coders use the three code sets when submitting medical claims to report the following:
CPT® codes: What the provider did
HCPCS codes: What the provider used
ICD-10-CM: Why the provider 'did' and 'used'.
An example can make it more clear.
If a urologist diagnoses a patient with bladder cancer and performs a bladder instillation of 1 mg of Bacillus Calmette-Guerin (BCG) to treat the tumor, the medical coder might assign:
CPT® codes (did): 51720 Bladder instillation of anticarcinogenic agent (including retention time)
HCPCS Level II code (used): J9030 BCG live intravesical instillation, 1mg
ICD-10-CM code (why): C67.9 Malignant neoplasm of bladder, unspecified
A. HCSPCS level I and II
HCPCS Level I: Current Procedural Terminology, Fourth Edition:
Procedures and services provided by physicians and other allied healthcare professionals
HCPCS Level II codes :
Consist of drugs, supplies, equipment, non-physician services, and services not represented in CPT
Example:
J9355: Injection, trastuzumab, excludes biosimilar, 10 mg.
G9631: Patient sustained ureter injury at the time of surgery or discovered subsequently up to 30 days post-surgery
C1823: Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads
V2599: Contact lens, other type
B.
HCPCS Code Ranges
A0021-A0999
Ambulance and Other Transport Services and Supplies
A2001-A2013
Matrix for Wound Management (Placental, Equine, Synthetic)
A4100
Skin Substitute Device
A4206-A8004
Medical And Surgical Supplies
Detailed list on the URL in Ref
Timeline:
Ref
https://www.aapc.com/resources/what-is-hcpcs
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