HCPCS Codes

What are HCPCS codes?
HCPCS stands for the Healthcare Common Procedure Coding System. HCPCS codes can are divided into two sets of codes. The first, or Level I, code set is a five-digit numeric code that contains the Physician's Current Procedural Terminology (CPT) maintained by the American Medical Association. The CPT is comprised of descriptive terms and identifying codes used primarily for billing for services provided by physicians and other healthcare professionals. The second code set, or Level II, is a code set for medical services not included in Level I, such as durable medical equipment, prosthetics, orthotics and supplies. These codes are alpha-numeric in that they begin with a single letter, such as an A or D in the case of durable medical equipment, followed by four numbers.

HCPCS codes were developed to simplify medical billing. There are a number of items with HCPCS codes that Medicare categorically does not cover. Whether an item with a HCPCS code is covered under a particular state Medicaid program depends on whether the item meets the state=s definition of durable medical equipment, prosthetics, orthotics, or any other service covered in that state.

HCPCS codes can be found (although not easily) on the CMS website, http://www.cms.hhs.gov/home/medicare.asp. Under coding, click on AHCPCS Release and Code Sets.@ Then click on AAlpha-Numeric HCPCS@ on the left. Click on the A2008 Alpha-Numeric HCPCS File@ and download the ZIP file.

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