Chapter 6: HCPCS Level 2 Exam with
Complete Solutions
Why were HCPCS developed? - ANS-created by CMS to report supplies, materials,
injections, and certain procedures and services that may not be defined in the CPT
code book
why do suppliers require the use of HCPCS codes when submitting claims - ANS-to
identify the items they are billing
what does the HCPCS descriptor assigned to a code represent - ANS-the official
definition of items and services that can be billed using that code
why are brand and trade names not used to describe the products represented by a
code - ANS-to avoid any appearance of endorsement or a product through HCPCS
level 2, the descriptors used to identify codes do not refer to the specific product
How are HCPCS level codes formed - ANS-codes begin with a single letter followed by
four digits
How are HCPCS level codes grouped - ANS-they are grouped by the type of service or
supply within a section of HCPCS level 2
in the HCPCS level code book, where are the information and instructions applying to a
specific category located - ANS-they are found at the beginning of each major category
who maintains the national permanent HCPCS level 2 codes - ANS-1. Blue Cross/Blue
Shield Association (BCBSA)
2. the Health Insurance Association of America (HIAA)
3. CMS
why can none of the parties (including CMS) make unilateral decisions regarding
permanent national codes - ANS-HCPCS level 2 is a national coding system
When are permanent national codes updated - ANS-once a year (on January 1) but
codes can be added or deleted throughout the year
miscellaneous/not otherwise classified codes - ANS-used when no existing national
code describes the item or service being billed
, what is an important note regarding claims for miscellaneous codes - ANS-1. claims
with misc. codes are manually reviewed
2. the item/service being billed must be clearly described
3. pricing information must be provided along with documentation to explain why the
beneficiary needs the item/service
temporary codes - ANS-allow insurers to establish codes needed before the next
January 1 annual update for permanent national codes or until consensus can be
achieved on a permanent national code
when are temporary codes updated - ANS-quarterly
when are temporary codes implemented - ANS-within 90 days
HCPCS table of drugs - ANS-designed to easily direct the coder to drug names and
their corresponding codes based on an alphabetic list of drugs with cross-references to
commercial names
IA - ANS--Intra-arterial administration
-administration of the drug is given in the artery
IV - ANS--intravenous administration
-administration of the drug is given into the vein
IM - ANS--Intramuscular administration
-administration of the drug via an injection into the muscle
IT - ANS--intrathecal
-administration of the drug is given into the subdural space of the spinal cord
SC - ANS--Subcutaneous administration
-administration of the drug via an injection just under the skin
INH - ANS--administration by inhaled solution
-administration of the drug by breathing it in
VAR - ANS--various routes of administration
-administration of the drug by various routes commonly administered into joints,
cavities, tissues, or topical applications
OTH - ANS--other routes of administration
-other administration methods like suppositories or catheter injections
ORAL - ANS--administered orally
-administration of the drug via taking it by mouth
Complete Solutions
Why were HCPCS developed? - ANS-created by CMS to report supplies, materials,
injections, and certain procedures and services that may not be defined in the CPT
code book
why do suppliers require the use of HCPCS codes when submitting claims - ANS-to
identify the items they are billing
what does the HCPCS descriptor assigned to a code represent - ANS-the official
definition of items and services that can be billed using that code
why are brand and trade names not used to describe the products represented by a
code - ANS-to avoid any appearance of endorsement or a product through HCPCS
level 2, the descriptors used to identify codes do not refer to the specific product
How are HCPCS level codes formed - ANS-codes begin with a single letter followed by
four digits
How are HCPCS level codes grouped - ANS-they are grouped by the type of service or
supply within a section of HCPCS level 2
in the HCPCS level code book, where are the information and instructions applying to a
specific category located - ANS-they are found at the beginning of each major category
who maintains the national permanent HCPCS level 2 codes - ANS-1. Blue Cross/Blue
Shield Association (BCBSA)
2. the Health Insurance Association of America (HIAA)
3. CMS
why can none of the parties (including CMS) make unilateral decisions regarding
permanent national codes - ANS-HCPCS level 2 is a national coding system
When are permanent national codes updated - ANS-once a year (on January 1) but
codes can be added or deleted throughout the year
miscellaneous/not otherwise classified codes - ANS-used when no existing national
code describes the item or service being billed
, what is an important note regarding claims for miscellaneous codes - ANS-1. claims
with misc. codes are manually reviewed
2. the item/service being billed must be clearly described
3. pricing information must be provided along with documentation to explain why the
beneficiary needs the item/service
temporary codes - ANS-allow insurers to establish codes needed before the next
January 1 annual update for permanent national codes or until consensus can be
achieved on a permanent national code
when are temporary codes updated - ANS-quarterly
when are temporary codes implemented - ANS-within 90 days
HCPCS table of drugs - ANS-designed to easily direct the coder to drug names and
their corresponding codes based on an alphabetic list of drugs with cross-references to
commercial names
IA - ANS--Intra-arterial administration
-administration of the drug is given in the artery
IV - ANS--intravenous administration
-administration of the drug is given into the vein
IM - ANS--Intramuscular administration
-administration of the drug via an injection into the muscle
IT - ANS--intrathecal
-administration of the drug is given into the subdural space of the spinal cord
SC - ANS--Subcutaneous administration
-administration of the drug via an injection just under the skin
INH - ANS--administration by inhaled solution
-administration of the drug by breathing it in
VAR - ANS--various routes of administration
-administration of the drug by various routes commonly administered into joints,
cavities, tissues, or topical applications
OTH - ANS--other routes of administration
-other administration methods like suppositories or catheter injections
ORAL - ANS--administered orally
-administration of the drug via taking it by mouth
