HCPCS Codes - Medical Procedures, Supplies & DME Codes - s5 Codes
HCPCS Procedure, Supply & DME (Durable Medical Equipment) Codes ("s5" Codes):- S5000 prescription drug generic HCPCS Code Code
- S5001 prescription drug brand name HCPCS Code Code
- S5010 5 dextrose 045 normal saline 1000 HCPCS Code Code
- S5011 5 dextrose lactated ringers 1000 ml HCPCS Code Code
- S5012 5 dextrose potassium chloride 1000 ml HCPCS Code Code
- S5013 5 dextrose045 normal saline potassium chloride HCPCS Code Code
- S5014 5 dextrose045 normal saline potassium chloride HCPCS Code Code
- S5035 home infusion therapy routine service infusion HCPCS Code Code
- S5036 home infusion therapy repair infusion device HCPCS Code Code
- S5100 day care services adult per 15 HCPCS Code Code
- S5101 day care services adult per half HCPCS Code Code
- S5102 day care services adult per diem HCPCS Code Code
- S5105 day care services centerbased services not HCPCS Code Code
- S5108 home care training home care client HCPCS Code Code
- S5109 home care training home care client HCPCS Code Code
- S5110 home care training family per 15 HCPCS Code Code
- S5111 home care training family per session HCPCS Code Code
- S5115 home care training nonfamily per 15 HCPCS Code Code
- S5116 home care training nonfamily per session HCPCS Code Code
- S5120 chore services per 15 minutes HCPCS Code Code
- S5121 chore services per diem HCPCS Code Code
- S5125 attendant care services per 15 minutes HCPCS Code Code
- S5126 attendant care services per diem HCPCS Code Code
- S5130 homemaker service nos per 15 minutes HCPCS Code Code
- S5131 homemaker service nos per diem HCPCS Code Code
- S5135 companion care adult eg iadladl per HCPCS Code Code
- S5136 companion care adult eg iadladl per HCPCS Code Code
- S5140 foster care adult per diem HCPCS Code Code
- S5141 foster care adult per month HCPCS Code Code
- S5145 foster care therapeutic child per diem HCPCS Code Code
- S5146 foster care therapeutic child per month HCPCS Code Code
- S5150 unskilled respite care not hospice per HCPCS Code Code
- S5151 unskilled respite care not hospice per HCPCS Code Code
- S5160 emergency response system installation testing HCPCS Code Code
- S5161 emergency response system service fee per HCPCS Code Code
- S5162 emergency response system purchase only HCPCS Code Code
- S5165 home modifications per service HCPCS Code Code
- S5170 home delivered meals including preparation per HCPCS Code Code
- S5175 laundry service external professional per order HCPCS Code Code
- S5180 home health respiratory therapy initial evaluation HCPCS Code Code
- S5181 home health respiratory therapy nos per HCPCS Code Code
- S5185 medication reminder service nonfacetoface per month HCPCS Code Code
- S5190 wellness assessment performed nonphysician HCPCS Code Code
- S5199 personal care item nos each HCPCS Code Code
- S5497 home infusion therapy catheter care HCPCS Code Code
- S5498 home infusion therapy catheter care HCPCS Code Code
- S5501 home infusion therapy catheter care HCPCS Code Code
- S5502 home infusion therapy catheter care HCPCS Code Code
- S5517 home infusion therapy all supplies necessary HCPCS Code Code
- S5518 home infusion therapy all supplies necessary HCPCS Code Code
- S5520 home infusion therapy all supplies including HCPCS Code Code
- S5521 home infusion therapy all supplies including HCPCS Code Code
- S5522 home infusion therapy insertion peripherally inserted HCPCS Code Code
- S5523 home infusion therapy insertion midline venous HCPCS Code Code
- S5550 insulin rapid onset 5 units HCPCS Code Code
- S5551 insulin most rapid onset lispro aspart HCPCS Code Code
- S5552 insulin intermediate acting nph lente 5 HCPCS Code Code
- S5553 insulin long acting 5 units HCPCS Code Code
- S5560 insulin delivery device reusable pen 15 HCPCS Code Code
- S5561 insulin delivery device reusable pen 3 HCPCS Code Code
- S5565 insulin cartridge use insulin delivery device HCPCS Code Code
- S5566 insulin cartridge use insulin delivery device HCPCS Code Code
- S5570 insulin delivery device disposable pen including HCPCS Code Code
- S5571 insulin delivery device disposable pen including 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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