While CPT stands for Current Procedural Terminology, HCPCS stands for Healthcare Common Procedure Coding System. These are two different code sets for medical billing, and both can be used to submit claims.
The CPT codes are Level I HCPCS codes maintained by the American Medical Association (AMA) while HCPCS is maintained by Centers for Medicare and Medicaid Services (CMS). The Level I codes are numeric such as 99213 for a mid-level office visit.
The Level II HCPCS is a standardized coding system which is used to identify products, supplies, and services not covered in the CPT codes. Referred to as alpha-numeric codes, these codes consist of a single alphabetical letter followed by four numeric digits.
Which code set you use should be based on choosing the code which accurately describes the service that is performed. Whether that should be a CPT or a HCPCS code must be determined by the provider.
You need to be well-versed with HCPCS CPT code changes and rules to accurately describe the service that is performed. But doing so is not an easy task; it takes up a lot of your time as well.
However, there are various one-stop medical coding websites which will certainly help you get on top of the latest HCPCS CPT code changes so that you know how to code right. Normally, such coding websites come stored with all CPT and HCPCS coding know how and other information that will help you find and use CPT and HCPCS codes more easily.
In other words, such websites will guide you through current modifiers, code additions and deletions, among a host of other information pertaining to HCPCS/CPT codes. So go for one today!
Tuesday, May 1, 2012
CPT Codes 77002, not 77003 with 64640
If your payer denies 77003 when you bill it with 64640, stating that the codes are mutually exclusive, can you use 77002 instead for the guidance (C-arm imaging) of the needle?
Yes you can use 77002 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]). This often is the complaint CPT code to report in conjunction with 64640 (desctruction by neurolytic agent; other peripheral nerve or branch).
The reason is: Code 77002 describes fluoroscopic guidance during pain management injection procedures when your physician needs guidance for needle placement in areas other than the spine. If you submit 64640, it signals the payer that you’re not reporting a spinal injection.
Code 77003 is for fluoroscopic guidance of the procedures included in the descriptor. The injection represented by 64640 falls outside those parameters.
If your provider performed the destruction procedure in an ambulatory surgery center or hospital outpatient department, append modifier 26 (professional component) to report your provider’s professional component of the fluoro-scopic needle guidance. You also need to check with your local payer about specific guidelines for these procedures. The most recent CCI edits do not bundle 77002 and 64640 as a comprehensive/component pair or as mutually exclusive. But you need to keep a check on whether your local payer has different bundling policies.
If you want to know more on this and get the complete list of CPT codes, there are various one-stop medical coding websites to get you there. Some websites also offer free trial, which you can choose to go for before registering yourself for one. So get going!
Yes you can use 77002 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]). This often is the complaint CPT code to report in conjunction with 64640 (desctruction by neurolytic agent; other peripheral nerve or branch).
The reason is: Code 77002 describes fluoroscopic guidance during pain management injection procedures when your physician needs guidance for needle placement in areas other than the spine. If you submit 64640, it signals the payer that you’re not reporting a spinal injection.
Code 77003 is for fluoroscopic guidance of the procedures included in the descriptor. The injection represented by 64640 falls outside those parameters.
If your provider performed the destruction procedure in an ambulatory surgery center or hospital outpatient department, append modifier 26 (professional component) to report your provider’s professional component of the fluoro-scopic needle guidance. You also need to check with your local payer about specific guidelines for these procedures. The most recent CCI edits do not bundle 77002 and 64640 as a comprehensive/component pair or as mutually exclusive. But you need to keep a check on whether your local payer has different bundling policies.
If you want to know more on this and get the complete list of CPT codes, there are various one-stop medical coding websites to get you there. Some websites also offer free trial, which you can choose to go for before registering yourself for one. So get going!
CPT/HCPCS Coding Changes
CPT is the acronym for Current Procedural Terminology while HCPCS stands for Healthcare Common Procedure Coding System. While the former is a uniform coding system comprising descriptive terms and identifying codes that are used to identify medical services and procedures provided by physicians and other healthcare professionals, the latter is a standardized coding system that is mainly used to identify products, supplies and services not found in the CPT. HCPCS lookup is normally referred to Level II HCPCS codes.
At the start of every calendar year, CPT and HCPCS code sets and manuals are updated; the changes are inclusive of coding additions, deletions and replacements.
The HIPAA transaction and code set rule calls for usage of the code set that is valid at the time that the service is provided. There’s no grace period as such during which discontinued codes may be used.
In order to boost timely payment of claims, all CPT and HCPCS codes submitted for reimbursement must be current and active as on the date on which the service is provided.
For the most current CPT HCPCS codes, there are one-stop medical coding websites where you can head to. Such one-stop shop websites teach coders to make use of CPT HCPCS codes using real world medical examples.
Such comprehensive resources also help just-in coders succeed by providing basic instruction on the structure, rules, and guidelines relating to CPT/ HCPCS coding. Here, you can even find the most common coding issues you are likely to encounter as a beginner in this profession.
So if you are looking for a complete explanation of symbols and formatting used in CPT/HCPCS coding, these one stop shops are just right for you.
At the start of every calendar year, CPT and HCPCS code sets and manuals are updated; the changes are inclusive of coding additions, deletions and replacements.
The HIPAA transaction and code set rule calls for usage of the code set that is valid at the time that the service is provided. There’s no grace period as such during which discontinued codes may be used.
In order to boost timely payment of claims, all CPT and HCPCS codes submitted for reimbursement must be current and active as on the date on which the service is provided.
For the most current CPT HCPCS codes, there are one-stop medical coding websites where you can head to. Such one-stop shop websites teach coders to make use of CPT HCPCS codes using real world medical examples.
Such comprehensive resources also help just-in coders succeed by providing basic instruction on the structure, rules, and guidelines relating to CPT/ HCPCS coding. Here, you can even find the most common coding issues you are likely to encounter as a beginner in this profession.
So if you are looking for a complete explanation of symbols and formatting used in CPT/HCPCS coding, these one stop shops are just right for you.
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