tci ED Coding & Reimbursement Alert - 2020 Issue Q2

Reader Question: Here's How to Differentiate HCPCS, CPT®

Question: When should we report HCPCS Level II codes versus CPT® codes? Are HCPCS Level II codes just for drugs? Massachusetts Subscriber Answer: Healthcare Common Procedure Coding System (HCPCS) Level I codes are the code set providers use to report medical procedures and professional services furnished in ambulatory or outpatient settings, including physician visits to inpatients, says the Centers for Medicare & Medicaid Services (CMS) in a Medicare Learning Network fact sheet. HCPCS Level I codes are numeric and are also known as CPT® codes, which were developed, copyrighted, and are maintained by the American Medical Association (AMA). HCPCS...

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