HCPCS Level II Codes

Established in 1978, Healthcare Common Procedure Coding System (HCPCS) is a two-tiered system - AMA's CPT and HCPCS Level II. These days, HCPCS I (CPT) and Level II codes must be reported for most medical services and supplies provided in outpatient settings to Medicare and Medicaid patients.


HCPCS Level II was developed by the CMS for reporting services not covered by CPT coding system. Till the year 2004, there was a third level of HCPCS codes, the use of which was discontinued to adhere to consistent coding standards.


Millions of medical products are described by Level II codes. However, no actual products are named in the code descriptions. What's more, development of the codes occurs independently of issues concerning reimbursement.


The Level II codes comprise one alpha character (A through V) followed by four digits. However the letter "I" is not used because sometimes it's often confused with the number "1"; Likewise several other letters are not used. Each letter category embraces an area or other areas of related products and services.


HCPCS modifiers: As in CPT codes, HCPCS Level II codes also require the use of modifiers to capture the exact nature of the service. There are two levels of HCPCS modifiers. The Level I modifiers are two numeric digits that can be found in the CPT book. The Level II modifiers on the other hand are two alphabetic or alphanumeric digits.


Unlisted HCPCS codes: While reporting HCPCS Level II services, it might sometimes be necessary to use an unlisted HCPCS code.


Who uses Level II HCPCS: These codes are used by both public and private health plans.


Where can you find HCPCS codes: You can find these codes if you glide through the CMS Website; though they are not that readily available