HCPCS codes

[leslie7071]

I am still fairly new at coding and was wondering, when are the HCPCS codes used? I know for injections, I use them but in what other scenarios and what Payers cover the codes? My brain is trying to get soon much information because I do want to be a great coder, lol.

Thank you!!

 

[ardithch]

I would highly recommend buying a HCPCS book from the AMA or AAPC. It's called "HCPCS Level II Expert" and includes codes that Medicare is trying out before they decide whether to make them into permanent codes, at which time, they create a CPT code instead. It also includes many modifiers not listed in your CPT manual which you need to know for Medicare (and many payers use them), as well as injection codes, DME codes, medications, etc.

Hope this helps!

Ardith, CGSC

 

[tracylc10]

I am fairly new too and this is a question I have also. When do you know that you have to use a HCPCS code? I am working for an OB/Gyn office and have questions about yearly exams. I know that Medicare does not cover the preventive visits every year, only every 2 years. We had a new 70 yr old pt come in for her Annual Exam and she had already had one last year with another provider. My physicians want to code this with an office visit E&M code, 99201-99205. I have been researching this and I almost think that it should not be coded as such and that they should code it G0439. They did order a mammo as well, but did not do a pap.

Any insight on this would be greatly appreciated. Thank you.
Tracy