Healthcare Common Procedure Coding System

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Healthcare Common Procedure Coding System (HCPCS)

The Healthcare Common Procedure Coding System (HCPCS, pronounced "Hick-Picks") is a set of health care procedure codes established by the United States Centers for Medicare and Medicaid Services (CMS).

Etymology

The acronym HCPCS originally stood for HCFA Common Procedure Coding System, a coding system developed by the Health Care Financing Administration (now CMS) to coordinate the coding systems used by Medicare and Medicaid. Over time, the acronym was kept but the name was changed to Healthcare Common Procedure Coding System.

Description

HCPCS is used to report medical procedures and services to federal health programs and many private health insurance programs. It includes three levels of codes:

  • Level I consists of the American Medical Association's Current Procedural Terminology (CPT) codes and is numeric.
  • Level II codes are alphanumeric and primarily include non-physician services such as ambulance services and prosthetic devices
  • Level III codes, also known as local codes, were developed by state Medicaid agencies, Medicare contractors, and private insurers for use in specific programs and jurisdictions.

The purpose of the HCPCS is to provide a standardized coding system for describing the specific items and services provided in the delivery of health care. Such coding is necessary for Medicare, Medicaid, and other health insurance programs to ensure that insurance claims are processed in an orderly and consistent manner.

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