When we think of medical billing and coding our first thought is of the coding systems that are critical to the process.
So what is a HCPCS Code?
A HCPCS (pronounced like hicks picks) code is not unlike any other billing code that is used to describe the service, treatment or supplies that can be provided to a patient. The unique difference is the fact that these codes are divided into level I and level II codes.
HCPCS II codes include but are not limited to:
HCPCS level I
So why do we need both HCPCS Level I and CPT- 4 codes if they are identical?
This is a bit confusing but CPT-4 codes were designed for billing to private and commercial health insurance carriers and HCPCS level I codes were designed for billing to Medicare, Medicaid and some other payers. CMS adopted the same codes as the CPT-4, so for billing purposes the codes are the same but the main difference depends on who you are billing to.
When 99214 is billed to a commercial carrier it is considered a CPT-4 code
When 99214 is billed to Medicare it is considered a HCPCS level I code.
HCPCS Level II codes
HCPCS Level II codes are used to identify products, services, drugs and supplies, including durable medical equipment, and they are used as temporary codes when a valid code does not exist yet.