Chapter 9 Level II National Codes (HCPCS)

HCPCS alphanumeric codes are also known as:

Level II codes

Medicare and other federal payers do not recognize __ codes.

S

What types of codes are not recognized by Medicare and other federal payers but may be useful for claims to some private payers?

S codes

The entries in the index of the National Codes may be listed under more than one __ term.

main

Reporting of National Codes is __ on all Medicare and Medicaid claims submitted to report professional services, procedures, and supplies.

mandatory

A modifier:

provides additional information to the third-party payer

What year did CMS develop and publish HCPCS?

1983

This modifier indicates required Waiver of Liability statement issued.

GA

Subset HCPCS modifier indicating denial expected as not reasonable or necessary.

GZ

HCPCS stands for:

Healthcare Common Procedure Coding System

K codes are used to identify:

The use of durable medical equipment

J codes do not include drug __.

administration

Codes for Chemotherapy drugs J9000-J9999 only include the __ of the drug.

cost

How often are Category III codes released?

twice a year

The rules that govern coding in various health care settings are:

variable

HCPCS codes have how many digits?

5

Level II National Modifiers are located in the introduction section of the HCPCS and also in Appendix __ of CPT.

A

Level II National Modifiers are found in the introduction section of HCPCS and also in what Appendix of CPT?

Appendix A

Subset HCPCS modifier indicating the service was provided by a resident under a teaching physician's direction.

GC

Subset HCPCS modifier indicating an "Opt out" physician providing emergency service.

GJ

HCPCS is a collection of codes that represent the following:

Procedures, supplies, products, and services

G codes are used to identify:

Professional procedures and services that would otherwise be reported with a CPT code but no CPT code has been established

HCPCS codes that are used to identify services that would not be reported with a CPT code, such as drugs, biologicals, and types of medical equipment/services which are not identified by Level II National codes.

Q