Outpatient Facility Coding Alert - 2020 Issue 5
Reader Question: Here's How to Differentiate HCPCS, CPT®
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Article Overview
This reader Q&A addresses the difference between HCPCS Level I and HCPCS Level II codes, with a focus on how the two code sets are organized and the kinds of items and services they are used to represent. It is relevant for coders, billing staff, and compliance professionals who need a high-level orientation to Medicare-related coding terminology and the organizations that maintain these code sets. The article also references how CMS describes the role of HCPCS Level II on claims and clarifies that the discussion goes beyond drugs and supplies to include other categories of items and services.
Why This Topic Matters
Understanding the distinction between these code sets helps revenue cycle and coding staff route claims and interpret payer guidance more accurately.
What You Will Learn
- How HCPCS Level I and HCPCS Level II are distinguished at a high level
- Which general categories of items and services are associated with HCPCS Level II
- Which organizations are referenced as maintaining the code sets
- How CMS is described in relation to HCPCS Level II claim processing
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Compliance professionals
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