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. Hcpcs level ii codes exisit to report drugs, services, & supplies, but codes are needed to be implement private payer policies & programs for claims processing hcpcs modifiers clarify services & procedures performed by providers. For many medical practices, cpt codes describe the majority of services performed and reported by their cliniciansso, it is tempting to ignore the healthcare common procedure code set (hcpcs) and simply buy new cpt and icd-9 books each year.
Level ii codes are the hcpcs alphanumeric code set and primarily include non-physician products, supplies, and procedures not included in cpt level iii codes, also called hcpcs local codes, were developed by state medicaid agencies, medicare contractors, and private insurers for use in specific programs and jurisdictions. Checkpoint: applying level ii hcpcs modifiers resource: table 62 on p 195 of medical insurance apply the appropriate level ii hcpcs code modifier for each of the following examples explain your. Hcpcs level ii modifiers are page 4 of 7 like cpt codes, the use of modifiers requires explicit understanding of the purpose of each modifier. Level ii codes describing the item if the supply is furnished during the same visit as an evaluation and management (e/m) service, the supply is normally part of the e/m and will be denied as incidental to the e/m.
If more than one level ii modifier applies, the hcpcs code is repeated on another line with the appropriate level ii modifier: for example, code 26010, drainage of finger abscess simple, done on the left thumb and second finger would be coded using 26010fa and 26010f1. The following hcpcs level ii modifiers are added, as appropriate, primarily to codes for procedures performed on paired organs (eg, eyelids, fingers, toes, or arteries, etc. Apply the appropriate level ii health care common procedure coding system (hcpcs) code modifier for each of the following examples explain your rationale for each selection explain your rationale for each selection. 99 multiple modifiers hcpcs modifiers hcpcs level ii modifiers 1329 add-on code with an appropriate primary code for e/m service.
Modifier -57 replaces hcpcs level ii modifier qi (decision for major surgery) modifier -57 should be used only in cases when the decision for surgery was made during the preoperative period, the day before or the day, of a major surgical procedure (procedures with 90 days of follow-up. 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-4 codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (dmepos) when used outside a physician's office. Apply the appropriate level ii hcpcs code modifier for each of the following examples explain your rational. This page gives an overview and background information for the healthcare common procedure coding system (hcpcs) coding system the hcpcs level ii coding system is a comprehensive, standardized system that classifies similar products that are medical in nature into categories for the purpose of efficient claims processing.
Applying level ii hcpcs modifiers apply the appropriate level ii healthcare common procedure coding system (hcpcs) code modifier for each of the following examples explain your rationale for each selection. Hcpcs modifiers, like cpt modifiers, are always two characters, and are added to the end of a hcpcs or cpt code with a hyphen when differentiating between a cpt modifier and a hcpcs modifier, all there's one simple rule: if the modifier has a letter in it, it's a hcpcs modifier. Level ii of the hcpcs are alphanumeric codes consisting of one alphabetical letter followed by four numbers and are managed by the centers for medicare and medicaid services (cms) these codes identify non-physician services such as ambulance services, durable medical equipment, and pharmacy. It is important to note here that for opps, if there are both a cpt and hcpcs level ii code for the service provided, cms requires that the hcpcs level ii code be used for example, use temporary hcpcs level ii code q0081 instead of cpt code 90780 for infusion therapy for hospital services.
Another important differentiation between hcpcs level ii codes and cpt codes is the level of use for example, when a cpt code and a hcpcs code have the same definition, the medical coder must use the cpt code. Apply the appropriate level ii health care common procedure coding system (hcpcs) code modifier for each of the following examples explain your rationale for each selection injection on the left hand thumb.