Table Of ContentH'C'P'C'S
Millennium Edition
Health Care Financing Administration
Common
Procedure
Coding System
^
National Level II
Medicare Codes
Color Coded
2001
rsns
M.
OTHER TITLES OF INTEREST
CODING AND REIMBURSEMENT
Codelink® CPT & ICD-9-CM Code Linkage Series
Collections Made Easy!
CPT & HCPCS Coding Made Easy!
E/M Coding Made Easy!
4'in-l Master Coder Series
HCPCS Coders Choice®, Color Coded, Thumb Indexed
Health Insurance Carrier Directory
ICD-9-CM, Coders Choice®, Thumb Indexed
ICD-9-CM, TimeSaver®, Ring Binder, Tab Indexed
ICD-9-CM Coding For Physicians' Offices
ICD-9-CM Coding Made Easy!
Medicare Rules and Regulations
Physicians Fees
Reimbursement Manualfor the Medical Office
Working with Insurance and Managed Care Plans
PRACTICE MANAGEMENT
365 Ways to Manage the Business Private Practice
Capitation: Tools, Trends, Traps & Techniques
Computerizing Your Medical Office
Designing and Building Your Professional Office
Doctor Business
Encyclopedia ofPractice and Financial Management
Getting Paid for What You Do
Health Information Management
The Managed Care Handbook
Managing Medical Office Personnel
Marketing Strategiesfor Physicians
McGraw-Hill Pocket Guide to Managed Care
Medical Marketing Handbook
Medical Office Policy Manual
Medical Practice Forms
Medical Practice Handbook
Medical StaffPrivileges
Negotiating Managed Care Contracts
Patient Satisfaction
Patients Build Your Practice
Physician's Office Laboratory
Professional and Practice Development
Promoting Your Medical Practice
Sur\'iving a Competitive Health Care Market
AVAILABLE FROM YOUR LOCAL MEDICAL
BOOK STORE OR CALL 1-800-MED-SHOP
OTHER TITLES OF INTEREST
FINANCIAL MANAGEMENT
Accounts Receivable Managementfor the Medical Practice
Achieving Profitability with a Medical Office System
Business Venturesfor Physicians
Financial Planning Workbookfor Physicians
Financial Valuation of Your Practice
Pension Plan Strategies
Physician Financial Planning in a Changing Environment
Securing Your Assets
Selling or Buying a Medical Practice
RISK MANAGEMENT
Behavioral Types and the Art ofPatient Management
Belli: For Your Malpractice Defense
Law, Liability and Ethicsfor Medical Office Personnel
Malpractice Depositions
Medical Malpractice: A Physician's Guide
Testifying in Court
DICTIONARIES AND OTHER REFERENCE
Health & Medicine on the Internet
Isler's Patient Guide to Medical Terminology
Medical Acronyms, Eponyms andAbbreviations
Medical Phrase Index
Medical Word Building
Medico Mnemonica
Medico-Legal Glossary
Spanish/English Handbookfor Medical Professionals
MEDICAL REFERENCE AND CLINICAL
Drugs ofAbuse
Gastroenterology: Problems in Primary Care
Hematology: Diagnosis and Treatment ofBlood Disorders
Medical Proceduresfor Referral
Neurology: Problems in Primary Care
Orthopaedics: Problems in Primary Care
Patient Care Emergency Handbook
Patient Care Flowchart Manual
Patient Care Proceduresfor Your Practice
Pulmonary Medicine: Problems in Primary Care
Urology: Problems in Primary Care
AVAILABLE FROM YOUR LOCAL MEDICAL
BOOK STORE OR CALL 1-800-MED-SHOP
H'C'P'C'S
Millennium Edition
Health Care Financing Administration
Common
Procedure
Coding System
National Level II
Medicare Codes
Color Coded
2001
nCTTB
ISBN 1-57066-194-4 (Coder's Choice)
ISBN 1-57066-195-2 (Timesaver Binder)
ISBN 1-57066-196-0 (Codes on Disk)
Practice Management Information Corporation (PMIC)
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Printed in the United States of America
Copyright© 2(X)0 by Practice Management Information Corporation, Los
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this publication may be reproduced, stored in a retrieval system, or
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at http://www.medicalbookstore.com, or by calling 1-800-MED-SHOP.
FOREWORD
(
The HCFACommon Procedure Coding System (HCPCS), National Level
II, is a listing of codes and descriptive terminology used for reporting
the provision of supplies, materials, injections and certain services and
procedures to Medicare. HCPCS 2001 is the most recent revision of the
HCPCS National Level II codes. The changes that appear in this revision
have been prepared by our editorial staff using the November 2000
HCPCS revisions released by the Health Care Financing Administration.
HCPCS National Level II codes are now effective January 1st of each
year.
Even though HCPCS National Level II codes have been in use since
1983, there is still some confusion among health care professionals
regarding when and how to use these codes instead of the more familiar
CPT codes. In addition, due to what is known as "carrier discretion," the
use, interpretation, and reimbursement pohcies for HCPCS National
Level II codes, which should be uniform nationwide, vary from carrier
to carrier. Add to this a third coding system, known as HCPCS Local
Level III, and the confusion becomes more understandable.
Unfortunately, many health care professionals deal with the confusion
by ignoring this coding system, to the serious detriment of their
reimbursement.
One of our goals as a pubhsher is to educate our customers about the
business of medicine. One of our most successful methods of
accomplishing this goal is to create publications about new or unfamiliar
concepts, such as HCPCS, that are similar in format and content to related
publications, such as CPT. This provides our customers with an
opportunity to learn and implement new concepts of vital importance to
their medical practice using formats, conventions and terminology that
they already use and understand.
James B. Davis, President
ui
DISCLAIMER
This publication is designed to offer basic information regarding coding
and billing of medical services, supplies and procedures using the
HCPCS coding system. The information presented is based upon material
obtained from the Health Care Financing Administration and the
experience and interpretations of the editors and publisher. Though all
of the information has been carefully researched and checked for
accuracy and completeness, the publisher accepts no responsibihty or
hability with regard to errors, omissions, misuse or misinterpretation.
IV
CONTENTS
(
INTRODUCTION
vii
Structure of HCPCS vii
Sections viii
Instructions for Use of HCPCS ix
Format of the Terminology ix
Guidelines x
HCPCS Modifiers x
Unlisted Procedure or Service xi
Special Report xii
HCPCS Code Changes xii
Special Coverage Symbols xiii
Durable Medical Equipment Regional Carriers (DMERCs) xiv
..
HCPCS on Disk xvi
TRANSPORTATION SERVICES
1
CHIROPRACTIC SERVICES 9
MEDICAL AND SURGICAL SUPPLIES 11
ADMINISTRATIVE, MISCELLANEOUS
AND INVESTIGATIONAL 35
ENTERAL AND PARENTERAL THERAPY 37
HOSPITAL OUTPATIENT PPS CODES 41
DENTAL PROCEDURES
83
DURABLE MEDICAL EQUIPMENT (DME) 115
G CODES FOR PROCEDURES
141
REHABILITATIVE SERVICES 153
CONTENTS
DRUGS ADMINISTERED OTHER THAN
ORAL METHOD 157
CHEMOTHERAPY DRUGS 181
K CODES: FOR DMERCS USE ONLY 187
ORTHOTIC PROCEDURES 207
PROSTHETIC PROCEDURES 237
MEDICAL SERVICES 265
PATHOLOGY AND LABORATORY 269
TEMPORARY CODES 273
DIAGNOSTIC RADIOLOGY SERVICES 283
PRTVATE PAYER CODES 285
VISION SERVICES 297
HEARING SERVICES 307
—
APPENDIX A MODIFIERS 311
—
APPENDIX B SUMMARY OF ADDITION
CHANGES AND REVISIONS 323
—
APPENDIX C TABLE OF DRUGS 445
INDEX 505
VI
