HCPCS Coding

HCPCS stands for Healthcare Common Procedure Coding System. It was developed
by the Centers for Medicine and Medicaid (CMS) for the purposes of recording and reporting
medical services and procedures (Gross, 2020). HCPCS has two levels (Gross, 2020). Level 1
codes are similar to current procedural terminology (CPT) codes while Level 2 codes are
alphanumeric codes (Gross, 2020).

Even though Level 1 codes of HCPCS are similar to CPT codes, it does not mean that
the two codes are the same. There are significant differences between HCPCS and other
codes, such as CPT and ICD. For instance, ICD codes are used to record diagnoses and CPT
are used to describe procedures that are performed on a patient or services that they receive
from a healthcare facility. HCPCS codes, particularly level 2 codes, describe not just the
services and procedures performed on a patient but also the various products and medical
equipment used on the patient (Gross, 2020). For instance, when recording services provided
to an injured patient who was given a wheel chair, CPT will only record the medical services
that were given to the patients and not the wheel chair. HCPCS will allow the coder to record
both the services and procedures performed on the patient as well as the wheelchair given to
the patient.

Secondly, HCPCS codes are more specific than other codes. For instance, when a
patient is injected with 20mg of a given pain relief drug, CPT codes will only state how the
drug was administered to the patient. However, a report using HCPCS code will have the
type of administration (injection), name of the drug, and the quantities of the drug used.

There are multiple reasons why coders should know how to code using HCPCS. The
most important one is that HCPCS are the main codes that are used to record and report

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medical services and procedures to Medicaid and Medicare. Thus, knowledge of HCPCS
ensures that coders use appropriate codes when dealing with patients that are covered by
Medicaid and Medicare.

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References

Gross, G. N. (2020). Coding Telemedicine Visits for Proper Reimbursement. Current allergy
and asthma reports, 20(11), 1-6. https://doi.org/10.1007/s11882-020-00970-0