seminar 5. hcpcs healthcare common procedure coding system level i codes are cpt codes (for...

55
Seminar 5

Upload: dale-lawrence

Post on 11-Jan-2016

234 views

Category:

Documents


1 download

TRANSCRIPT

Page 1: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

Seminar 5

Page 2: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

HCPCS Healthcare Common Procedure Coding

System Level I codes are CPT codes (for

procedures) Level II codes are HCPCS codes (for

durable medical equipment, ambulance transportation, insulin, etc.---things not covered by CPT codes)

Page 3: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

HCPCS codes were created in the 1980s Codes are five characters in length Begin with alpha A-V followed by four

numbers When people refer to HCPCS codes, they

are most likely referring to the level II codes

Page 4: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

HCPCS level II codes are organized according to the type depending on the purpose of the codes and the entity responsible for establishing and maintaining them. The five types are:

Permanent national codes Dental codes Miscellaneous codes Temporary codes Modifiers

Page 5: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

HCPCS modifiers Attached to any HCPCS level I (CPT) or

level II (HCPCS) code to provide additional information regarding the product or service reported

Adds another level of detail to an item or service

Page 6: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

A patient was supplied with an air pressure mattress. Report the HCPCS code:

a.E0181b.E0184c.E0185d.E0186

Page 7: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

A patient was supplied with an air pressure mattress. Report the HCPCS code:

a.E0181b.E0184c.E0185

d.E0186

Page 8: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

Magnetic resonance imaging without contrast followed by with contrast, left breast.

a.C8903-LTb.C8904-LTc.C8905-LTd.C8908-LT

Page 9: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

Magnetic resonance imaging without contrast followed by with contrast, left breast.

a.C8903-LTb.C8904-LT

c.C8905-LTd.C8908-LT

Page 10: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

A patient received an injection of hydrocortisone acetate, 15mg, for contact dermatitis.

a.J1700b.J1700, J1700c.J1720d.J1720, J1720

Page 11: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

A patient received an injection of hydrocortisone acetate, 15mg, for contact dermatitis.

a.J1700b.J1700, J1700c.J1720d.J1720, J1720

Page 12: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

A patient required catheterization for the collection of a specimen.

a.A4300b.A4305c.P9612d.P9615

Page 13: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

A patient required catheterization for the collection of a specimen.

a.A4300b.A4305

c.P9612d.P9615

Page 14: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

A patient received 2 mg leuprolide acetate for treatment of prostate cancer.

a.J1950b.J9217c.J9218, J9218d.J9219

Page 15: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

A patient received 2 mg leuprolide acetate for treatment of prostate cancer.

a.J1950b.J9217c.J9218, J9218d.J9219

Page 16: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

A patient in a drug and alcohol rehabilitation hospital received an injection of methadone by the treating physician

a.H0020b.H0029c.H0033d.J1230

Page 17: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

A patient in a drug and alcohol rehabilitation hospital received an injection of methadone by the treating physician

a.H0020b.H0029c.H0033d.J1230

Page 18: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

An 8 year-old boy is fitted with a long-arm cast. Service is performed in part by a resident under the direction of a teaching physician.

a.Q4007b.Q4007-GCc.Q4008-GCd.Q40010

Page 19: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

An 8 year-old boy is fitted with a long-arm cast. Service is performed in part by a resident under the direction of a teaching physician.

a.Q4007b.Q4007-GCc.Q4008-GCd.Q40010

Page 20: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

The patient’s family received 30 minutes of family training and counseling, which was provided for the purpose of child development.

a.T1025b.T1026c.T1027d.T1027, T1027

Page 21: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

The patient’s family received 30 minutes of family training and counseling, which was provided for the purpose of child development.

a.T1025b.T1026c.T1027

d.T1027, T1027

Page 22: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

A patient received a hand-held low vision aid.

a.V2020b.V2510c.V2600d.V2610

Page 23: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

A patient received a hand-held low vision aid.

a.V2020b.V2510

c.V2600d.V2610

Page 24: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

Modifiers

Page 25: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier AH?

Page 26: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier AH?

Clinical psychologist

Page 27: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier TA?

Page 28: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier TA?

Left foot, great toe

Page 29: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier SB?

Page 30: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier SB?

Nurse midwife

Page 31: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier E4?

Page 32: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier E4? Lower right eyelid

Page 33: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier FA?

Page 34: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier FA? Left hand, thumb

Page 35: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier NU?

Page 36: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier NU? New equipment

Page 37: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier RC?

Page 38: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier RC? Right coronary artery

Page 39: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier TC?

Page 40: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier TC? Technical component

Page 41: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier TD?

Page 42: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier TD? Registered nurse

Page 43: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier UQ?

Page 44: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

What is the HCPCS modifier UQ? Four patients served

Page 45: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

Drugs are listed in the HCPCS Table of Drugs according to:

a.Dosage to be usedb.Generic or chemical namec.Route of administrationd.Trade or brand name

Page 46: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

Drugs are listed in the HCPCS Table of Drugs according to:

a.Dosage to be usedb.Generic or chemical namec.Route of administrationd.Trade or brand name

Page 47: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

Mr. William Hansberry attended a local clinic’s administration of influenza vaccine at a local shopping mall. Mr. Hansberry asks that the clinic bill Medicare for the shot.

a. G0001b.G0008c. G0009d.G0010

Page 48: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

Mr. William Hansberry attended a local clinic’s administration of influenza vaccine at a local shopping mall. Mr. Hansberry asks that the clinic bill Medicare for the shot.

a. G0001

b.G0008c. G0009d.G0010

Page 49: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

Michael Lincoln presents to the dental clinic for a fluoride treatment. Michael has several cavities, and he is only 7 years of age.

a. D1110b.D1120c. D1203d.D1206

Page 50: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

Michael Lincoln presents to the dental clinic for a fluoride treatment. Michael has several cavities, and he is only 7 years of age.

a. D1110b.D1120c. D1203

d.D1206

Page 51: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

A 75 year old terminal lung cancer patient is admitted to hospice care for general inpatient care

a. T2042b.T2043c. T2044d.T2045

Page 52: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

A 75 year old terminal lung cancer patient is admitted to hospice care for general inpatient care

a. T2042b.T2043c. T2044

d.T2045

Page 53: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

Injection of Depo-Provera, 50 milligramsa. J1051b. J1055c. J1056d. J1060

Page 54: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

Injection of Depo-Provera, 50 milligrams

a.J1051b. J1055c. J1056d. J1060

Page 55: Seminar 5.  HCPCS  Healthcare Common Procedure Coding System  Level I codes are CPT codes (for procedures)  Level II codes are HCPCS codes (for durable

Questions???