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Healthcare Classifications and Terminologies

What is HCPCS?

The Healthcare Common Procedure Coding System (HCPCS) consists of two levels:

  1. HCPCS Level I codes – These are the CPT codes which consists of codes and descriptive terms that are used to report medical services and procedures furnished by physicians, other providers, and healthcare facilities. The CPT codes are maintained and updated annually by the American Medical Association (AMA).

  2. HCPCS Level II codes – these codes were developed by Centers for Medicare and Medicaid Services (CMS) to identify other services not found in the CPT codebook.

This tab will focus on the HCPCS Level II codes.  Refer to the CPT tab in this guide for additional information on CPT codes. 

Where are the guidelines for coding in HCPCS Level II?

The American Hospital Association publishes the Coding Clinic for HCPCS which provides coding advice on certain HCPCS Level II codes for hospitals, physicians and other health professionals who bill Medicare and also on CPT codes for hospitals.

It contains coding advice as designated by the four Cooperating Parties (American Hospital Association, American Health Information Management Association, Centers for Medicare and Medicaid Services, and National Center for Health Statistics) and the Editorial Advisory Board.  This quarterly newsletter is available for purchase.

Refer to payer policies for additional documentation and billing guidelines pertaining to reporting of procedures and services to payers.

Learn more about HCPCS.