HCPCS Codes - Medical Procedures, Supplies & DME Codes - g4 Codes
HCPCS Procedure, Supply & DME (Durable Medical Equipment) Codes ("g4" Codes):- G4000 Dermatology mips specialty set HCPCS Code Code
- G4001 Diagnostic radiology mips specialty set HCPCS Code Code
- G4002 Electrophysiology cardiac specialist mips specialty set HCPCS Code Code
- G4003 Emergency medicine mips specialty set HCPCS Code Code
- G4004 Endocrinology mips specialty set HCPCS Code Code
- G4005 Family medicine mips specialty set HCPCS Code Code
- G4006 Gastro-enterology mips specialty set HCPCS Code Code
- G4007 General surgery mips specialty set HCPCS Code Code
- G4008 Geriatrics mips specialty set HCPCS Code Code
- G4009 Hospitalists mips specialty set HCPCS Code Code
- G4010 Infectious disease mips specialty set HCPCS Code Code
- G4011 Internal medicine mips specialty set HCPCS Code Code
- G4012 Interventional radiology mips specialty set HCPCS Code Code
- G4013 Mental/behavioral health mips specialty set HCPCS Code Code
- G4014 Nephrology mips specialty set HCPCS Code Code
- G4015 Neurology mips specialty set HCPCS Code Code
- G4016 Neurosurgical mips specialty set HCPCS Code Code
- G4017 Nutrition/dietician mips specialty set HCPCS Code Code
- G4018 Obstetrics/gynecology mips specialty set HCPCS Code Code
- G4019 Oncology/hematology mips specialty set HCPCS Code Code
- G4020 Ophthalmology mips specialty set HCPCS Code Code
- G4021 Orthopedic surgery mips specialty set HCPCS Code Code
- G4022 Otolaryngology mips specialty set HCPCS Code Code
- G4023 Pathology mips specialty set HCPCS Code Code
- G4024 Pediatrics mips specialty set HCPCS Code Code
- G4025 Physical medicine mips specialty set HCPCS Code Code
- G4026 Physical therapy/occupational therapy mips specialty set HCPCS Code Code
- G4027 Plastic surgery mips specialty set HCPCS Code Code
- G4028 Podiatry mips specialty set HCPCS Code Code
- G4029 Preventive medicine mips specialty set HCPCS Code Code
- G4030 Pulmonology mips specialty set HCPCS Code Code
- G4031 Radiation oncology mips specialty set HCPCS Code Code
- G4032 Rheumatology mips specialty set HCPCS Code Code
- G4033 Skilled nursing facility mips specialty set HCPCS Code Code
- G4034 Speech language pathology mips specialty set HCPCS Code Code
- G4035 Thoracic surgery mips specialty set HCPCS Code Code
- G4036 Urgent care mips specialty set HCPCS Code Code
- G4037 Urology mips specialty set HCPCS Code Code
- G4038 Vascular surgery mips specialty set HCPCS Code Code
Back to list of HCPCS Procedure, Supply & DME Codes
HCPCS Medical Codes & Code Modifiers
(HCPCS is commonly pronounced Hick-Picks.)Each year, in the United States, health care insurers process over 5 billion claims for payment. For Medicare and other health insurance programs to ensure that these claims are processed in an orderly and consistent manner, standardized coding systems are essential. The HCPCS Level II Code Set is one of the standard code sets used for this purpose. The HCPCS is divided into two principal subsystems, referred to as level I and level II of the HCPCS. Level I of the HCPCS is comprised of CPT (Current Procedural Terminology), a numeric coding system maintained by the American Medical Association (AMA). The CPT is a uniform coding system consisting of descriptive terms and identifying codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals. These health care professionals use the CPT to identify services and procedures for which they bill public or private health insurance programs. Decisions regarding the addition, deletion, or revision of CPT codes are made by the AMA. The CPT codes are republished and updated annually by the AMA. Level I of the HCPCS, the CPT codes, does not include codes needed to separately report medical items or services that are regularly billed by suppliers other than physicians.
Level II of the HCPCS is a standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician's office. Because Medicare and other insurers cover a variety of services, supplies, and equipment that are not identified by CPT codes, the level II HCPCS codes were established for submitting claims for these items. The development and use of level II of the HCPCS began in the 1980's. Level II codes are also referred to as alpha-numeric codes because they consist of a single alphabetical letter followed by 4 numeric digits, while CPT codes are identified using 5 numeric digits.
In October of 2003, the Secretary of HHS delegated authority under the HIPAA legislation to CMS to maintain and distribute HCPCS Level II Codes. As stated in 42 CFR Sec. 414.40 (a) CMS establishes uniform national definitions of services, codes to represent services, and payment modifiers to the codes. Within CMS there is a CMS HCPCS Workgroup which is an internal workgroup comprised of representatives of the major components of CMS, as well as other consultants from pertinent Federal agencies. Prior to December 31, 2003, Level III HCPCS were developed and used by Medicaid State agencies, Medicare contractors, and private insurers in their specific programs or local areas of jurisdiction. For purposes of Medicare, level III codes were also referred to as local codes. Local codes were established when an insurer preferred that suppliers use a local code to identify a service, for which there is no level I or level II code, rather than use a "miscellaneous or not otherwise classified code." The Health Insurance Portability and Accountability Act of 1996 (HIPAA) required CMS to adopt standards for coding systems that are used for reporting health care transactions. We published, in the Federal Register on August 17, 2000 (65 FR 50312), regulations to implement this part of the HIPAA legislation. These regulations provided for the elimination of level III local codes by October 2002, at which time, the level I and level II code sets could be used. The elimination of local codes was postponed, as a result of section 532(a) of BIPA, which continued the use of local codes through December 31, 2003.
(Source: http://www.cms.hhs.gov/MedHCPCSGenInfo/)
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