Discuss the difference between Level 1: CPT Codes and Level II: HCPCS National Codes and give an example of each.
Level 1: CPT Codes are codes used for medical procedures, these consist of five digits. “Current Procedural Terminology (CPT), is a code set maintained by the American Medical Association (AMA)”, it is designed to describe medical, surgical, and diagnostic services accurately. It is used as a form of uniform communication across the medical field. The CPT Codes are not particularly private, as AMA has the sole copyright to the codes, so you have to “pay a license fee if you want to compare the Relative Value Unit (RVU) values to the CPT codes”. Everyone must have access to HCPCS codes as of the Health Insurance Portability and Accountability Act (HIPAA) of 1996.
CPT has three categories:
1. Standard CPT Codes,
2. CPT Codes specific for performance measurement,
3. CPT Codes that are specific for emerging technology and experimental.
Example of CPT codes:
1. Osteoplasty: facial bones, Augmentation would be 21208, Osteoplasty, facial bones: augmentation (autograft, allograft, or prosthetic implant).
2. Established office visit with problem focused history and exam, with straightforward medical decision making …show more content…
Healthcare Common Procedure Coding System (HCPCS), are sets of health care procedure codes that are based on the five digit CPT codes, to “provide standardized coding system to describe specific items and services to ensure that insurance claims are processed efficiently”. HCPCS codes are grouped by the type of service or supplies they represent and are updated yearly by the CMS. “Level II codes are required when reporting most medical services and supplies provided to Medicare and Medicaid patients and most private payers”. HCPCS can be accessed freely by those who use Medicare, Medicaid, or any other private
Level 1: CPT Codes are codes used for medical procedures, these consist of five digits. “Current Procedural Terminology (CPT), is a code set maintained by the American Medical Association (AMA)”, it is designed to describe medical, surgical, and diagnostic services accurately. It is used as a form of uniform communication across the medical field. The CPT Codes are not particularly private, as AMA has the sole copyright to the codes, so you have to “pay a license fee if you want to compare the Relative Value Unit (RVU) values to the CPT codes”. Everyone must have access to HCPCS codes as of the Health Insurance Portability and Accountability Act (HIPAA) of 1996.
CPT has three categories:
1. Standard CPT Codes,
2. CPT Codes specific for performance measurement,
3. CPT Codes that are specific for emerging technology and experimental.
Example of CPT codes:
1. Osteoplasty: facial bones, Augmentation would be 21208, Osteoplasty, facial bones: augmentation (autograft, allograft, or prosthetic implant).
2. Established office visit with problem focused history and exam, with straightforward medical decision making …show more content…
Healthcare Common Procedure Coding System (HCPCS), are sets of health care procedure codes that are based on the five digit CPT codes, to “provide standardized coding system to describe specific items and services to ensure that insurance claims are processed efficiently”. HCPCS codes are grouped by the type of service or supplies they represent and are updated yearly by the CMS. “Level II codes are required when reporting most medical services and supplies provided to Medicare and Medicaid patients and most private payers”. HCPCS can be accessed freely by those who use Medicare, Medicaid, or any other private