AHA Coding Clinic® for HCPCS - 2006 Issue 1
Agreement between CMS and AHA for clearinghouse
The American Hospital Association (AHA) is pleased to announce the signing of a memorandum of understanding with the Centers for Medicare & Medicaid Services (CMS) to provide a clearinghouse service on a subset of HCPCS codes. The AHA and CMS entered into this agreement to foster a better understanding of HCPCS usage. The AHA’s Central Office on HCPCS will handle the clearinghouse functions and will provide interpretation, promotion and explanations of the proper use of: 1. Level I HCPCS (CPT-4 codes) for hospital providers 2. The following range of Level II HCPCS codes for hospitals, physicians and other...
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Article Overview
This article explains a joint CMS and AHA effort to provide a clearinghouse for selected HCPCS material and to support consistent interpretation of coding guidance. It is relevant to hospital coding staff, physicians, other Medicare-billing professionals, and organizations that rely on HCPCS and CPT guidance. The piece also outlines the participating organizations and the general scope of the advisory and referral structure.
Why This Topic Matters
It helps readers understand how HCPCS-related guidance is being organized, which organizations are involved, and which broad coding areas are covered by the clearinghouse arrangement.
Article Sections
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Memorandum of understanding and clearinghouse purpose
Introduces the agreement between CMS and AHA and explains the purpose of the clearinghouse service. It frames the article around standardized interpretation and support for HCPCS-related inquiries.
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Scope of HCPCS material covered
Describes the broad HCPCS categories included in the clearinghouse arrangement and identifies the provider groups for whom the service is intended. It also notes a limited exclusion within one HCPCS category.
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Referral of other HCPCS-related inquiries
Explains that some coding inquiries are directed to other organizations or contractor entities. The section identifies the general types of inquiries that are handled outside the clearinghouse.
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Relationship to ICD-9-CM and advisory board participation
Places the clearinghouse model in the context of an existing editorial process and notes the advisory role of participating organizations. It also mentions related coordination among national coding organizations.
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Use of Coding Clinic guidance and reporting goals
Summarizes the intended role of the published guidance and its relationship to CMS policy and data quality objectives. It also describes the broader goal of supporting more consistent reporting and analysis.
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Questions and submission process
Provides information about how inquiries may be submitted to the clearinghouse. It points readers to the available submission form and the organization’s website.
What You Will Learn
- What the CMS and AHA agreement is intended to support
- Which broad HCPCS categories are included in the clearinghouse scope
- Which organizations are involved in advisory and referral roles
- How the clearinghouse relates to broader coding guidance and data quality efforts
- How questions may be submitted for review
Who Should Read This
- Hospital coders
- Health information management professionals
- Physicians and other Medicare-billing providers
- Compliance and revenue cycle staff
- Coding educators and advisory staff
Code Ranges Discussed
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