HCPC codes

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HCPC code is short for Health Care Procedure Code.

It is a code used by Medicare and other health insurance companies for re-imburesement purposes in the United States and some other countries.

HCPCS level 1 codes[edit | edit source]

Level I consists of the American Medical Association's Current Procedural Terminology (CPT) and is numeric.

HCPCS level 2 codes[edit | edit source]

HCPCS Level II codes are alphanumeric medical procedure codes, primarily for non-physician services such as ambulance services and prosthetic devices.

Types of Level II codes[edit | edit source]

The letters at the beginning of HCPCS Level II codes have the following meanings:[1]

  • A-codes (example: A0021): Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental
  • B-codes (example: B4034): Enteral and Parenteral Therapy
  • C-codes (example: C1300): Temporary Hospital Outpatient Prospective Payment System
  • D-codes: Dental Procedures
  • E-codes (example: E0100): Durable Medical Equipment
  • G-codes (example: G0008): Temporary Procedures & Professional Services
  • H-codes (example: H0001): Rehabilitative Services
  • J-codes (example: J0120): Drugs Administered Other Than Oral Method, Chemotherapy Drugs
  • K-codes (example: K0001): Temporary Codes for Durable Medical Equipment Regional Carriers
  • L-codes (example: L0112): Orthotic/Prosthetic Procedures
  • M-codes (example: M0064): Medical Services
  • P-codes (example: P2028): Pathology and Laboratory
  • Q-codes (example: Q0035): Temporary Codes
  • R-codes (example: R0070): Diagnostic Radiology Services
  • S-codes (example: S0012): Private Payer Codes
  • T-codes (example: T1000): State Medicaid Agency Codes
  • V-codes (example: V2020): Vision/Hearing Services

There are three important HCPCS Level 2[2] codes for digital mammograms that often used (G0202, G0204 and G0206).

HCPCS Level III codes[edit | edit source]

Level III codes, also called local codes, were developed by state Medicaid agencies, Medicare contractors, and private insurers for use in specific programs and jurisdictions. The use of Level III codes was discontinued on December 31, 2003, in order to adhere to consistent coding standards.[3]:2 Level III codes were different from the modern CPT Category III codes, which were introduced in 2001 to code emerging technology.

HIPAA mandate[edit | edit source]

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) instructed CMS to adopt a standard coding systems for reporting medical transactions.

HCPCS codes
HCPCS codes starting with A - B - C - D - E - F - F - G - H - I - J - K - L - M - N - O - P - Q - R - S - T - U - V - W - X - Y - Z

External links[edit | edit source]

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  1. "Procedure Code Overview". State of Wisconsin, Department of Health Services, Clinical Advisory Committee on Health and Emerging Technology. March 25, 2010. Retrieved 2010-12-12.
  2. "HCPCS Level II". AAPC. Retrieved 8 April 2019.
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Contributors: Prab R. Tumpati, MD