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Thread: HCPCS question - One of my associates

  1. #1
    Join Date
    Apr 2007
    Location
    Columbia River Chapter
    Posts
    11

    Smile HCPCS question - One of my associates

    Promo: Code Books
    One of my associates is taking a master coder class. This question came up on a practice test.. and I have no idea, nor does she.
    Anyone out there?

    What does a circle with the letter "i" in it indicate when placed next to a HCPCS code?

    a. The coverage is determined by the carrier
    b. Special coverage instructions apply
    c. That the code has been revised
    d. That the code is new

    The key in the HCPCS book has no letter i....AND each one of these options has it's own indicator already!
    a. The coverage is determined by the carrier - This is indicated with a Yellow Color Bar—Contractor Discretion, Issues that are left to “contractor discretion” are covered with a yellow bar. Contact the contractor for specific coverage information on those codes.

    b. Special coverage instructions apply – This would be indicated with a Blue Color Bar—Special Coverage Instructions, A blue bar for “special coverage instructions” over a code means that special coverage instructions apply to that code.

    c. That the code has been revised – This is indicated with a black triangle (▲) precedes a code with revised terminology or rules.

    d. That the code is new – This is indicated with a black circle (●) precedes a new code.

    HELP!!
    Thanks in advance

    Lisa Jensen, MHBL, FACMPE, CPC
    Physician Coding Consultant
    Reimbursement Management Consultants, Inc.
    Beaverton, OR
    PH - 503-475-3841
    Fax 503-848-8943

  2. #2
    Join Date
    Apr 2007
    Posts
    32

    Default

    Hi,

    I believe the answer is B.

    My HCPCS book is from Decision Health and it says on the introduction page that the symbol i with a circle is "Special Coverage Instructions Apply -- The references to the National Coverage Determinations Manual, additional Medicare Pub 100 manuals (Medicare Benefit Policy Manual, Medicare Claims Processing Manual, Medicare Program Integrity Manual), Medicare Statutes, and the Code of Federal Regulations (found in Appendix C) will give insight into the nature of the special coverage instructions."

    I never noticed this symbol before, so I learned something new today, thanks.
    K-jag

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