HCPCS Codes - Medical Procedures, Supplies & DME Codes - s4 Codes
HCPCS Procedure, Supply & DME (Durable Medical Equipment) Codes ("s4" Codes):- S4005 interim labor facility global labor occurring HCPCS Code Code
- S4011 vitro fertilization including but not limited HCPCS Code Code
- S4013 complete cycle gamete intrafallopian transfer gift HCPCS Code Code
- S4014 complete cycle zygote intrafallopian transfer zift HCPCS Code Code
- S4015 complete vitro fertilization cycle not otherwise HCPCS Code Code
- S4016 frozen vitro fertilization cycle case rate HCPCS Code Code
- S4017 incomplete cycle treatment cancelled prior stimulation HCPCS Code Code
- S4018 frozen embryo transfer procedure cancelled before HCPCS Code Code
- S4020 vitro fertilization procedure cancelled before aspiration HCPCS Code Code
- S4021 vitro fertilization procedure cancelled after aspiration HCPCS Code Code
- S4022 assisted oocyte fertilization case rate HCPCS Code Code
- S4023 donor egg cycle incomplete case rate HCPCS Code Code
- S4025 donor services vitro fertilization sperm embryo HCPCS Code Code
- S4026 procurement donor sperm sperm bank HCPCS Code Code
- S4027 storage previously frozen embryos HCPCS Code Code
- S4028 microsurgical epididymal sperm aspiration mesa HCPCS Code Code
- S4030 sperm procurement cryopreservation services initial visit HCPCS Code Code
- S4031 sperm procurement cryopreservation services subsequent visit HCPCS Code Code
- S4035 stimulated intrauterine insemination iui case rate HCPCS Code Code
- S4036 INTRAVAG CULT CASE RATE HCPCS Code Code
- S4037 cryopreserved embryo transfer case rate HCPCS Code Code
- S4040 monitoring storage cryopreserved embryos per 30 HCPCS Code Code
- S4042 management ovulation induction interpretation diagnostic tests HCPCS Code Code
- S4981 insertion levonorgestrelreleasing intrauterine system HCPCS Code Code
- S4988 Penile contracture device, manual, greater than 3 lbs traction force HCPCS Code Code
- S4989 contraceptive intrauterine device eg progestacert iud HCPCS Code Code
- S4990 nicotine patches legend HCPCS Code Code
- S4991 nicotine patches nonlegend HCPCS Code Code
- S4993 contraceptive pills birth control HCPCS Code Code
- S4995 smoking cessation gum HCPCS Code Code
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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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