HCPCS is a coding system used to organize medical claims in the US. It has two subsystems: Level I, which uses CPT codes, and Level II, which assigns codes to services not covered by CPT. Level III codes were discontinued in 2003. Knowledge of HCPCS coding is essential for medical administration jobs.
HCPCS is the standard acronym for Healthcare Common Procedure Coding System (HCPCS). The system is broken down into two subsystems, both designed to help streamline and organize the billions of medical claims that are processed for payment each year in the United States. The system uses computer data to encode and organize medical information and is continually updated as new medical procedures are invented. Knowledge of HCPCS coding is a specialty in medical administration and requires its users to stay current with changes.
Level I
HCPCS coding is divided into two primary subsystems, called level I and level II. Level I HCPCS coding includes Current Procedural Terminology (CPT) codes, which is a numeric coding system maintained by the American Medical Association (AMA). CPT codes numerically identify the medical services and procedures a patient has received, and the code consists of five numbers.
Level II
The HCPCS Level II of coding was established in the 1980s to assign codes to services, supplies and procedures not included in the CPT coding system, but still covered by and billed to insurance companies. The level II HCPCS code consists of a single letter followed by four numbers, instead of the standard five-digit CPT code.
Level III
Level III HCPCS codes were considered local codes that established a code for items or services not included in either of the previous two levels. These codes were discontinued on December 31, 2003 and are no longer considered valid codes for local or national jobs. As the healthcare industry continues to advance, the need to refine and expand the HCPCS coding continues; every time a new procedure or service is developed, a code that identifies it must also be established.
Job qualification
In-depth knowledge of HCPCS coding is a job skill that remains in high demand and has very promising prospects for years to come. For those in the field of medical administration, including those working in doctors’ offices, hospitals, and public and private health insurers, knowledge of health coding is essential as it is used on a daily basis. Encryption is essentially clearhouse governed, meaning that all information passes through the same source before being distributed; in this case, the clearinghouse includes the American Hospital Association (AHA) and the Center for Medicare and Medicaid Services (CMS). Together, they serve as a centralized location that maintains and deploys the system, as well as a source for answers to questions about the coding system.
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