HCPCS Level II Questions and Answers Already Passed

HCPCS Level II Questions and Answers Already Passed Why was the HCPCS coding system developed? The HCPCS system was created to cover medical services, supplies, and equipment not reported by CPT codes, ensuring that providers receive reimbursement for services and items not included in the ICD-10 or CPT coding systems. Is the use of HCPCS codes mandatory? Yes, HCPCS codes must be used on all Medicare and Medicaid claims, and many private insurers also require them. How are HCPCS codes structured? HCPCS codes are five characters long, starting with a letter followed by four numbers. They are updated annually by CMS. What are the main components of the HCPCS Level II book? The main components include the Alphabetic Index, Tabular List, Table of Drugs, Modifiers, Symbols and Conventions, and Annual Updates. Which item is not part of the HCPCS Level II book components: annual updates, drugs, ICD-10- CM Codes, or symbols and conventions? ICD-10-CM Codes Is it true that coders only need the main components of the HCPCS Level II book to assign codes? False What do the symbols and conventions in HCPCS Level II indicate? They provide important information regarding code assignment and reimbursement, such as new, revised, deleted, and reinstated codes, and services not covered by Medicare. What does the orange sun symbol represent in HCPCS Level II? Special Coverage Instructions, requiring coders to consult CMS' Internet Only Manuals (IOM) for details. What does the red circle with a slash symbol indicate in HCPCS Level II? Not Covered or Valid by Medicare, meaning the service, procedure, or item is not covered by Medicare. What does the orange asterisk symbol signify in HCPCS Level II? Carrier Discretion, meaning coverage must be determined by the third-party payer. What is the role of ASC status and payment indicators in HCPCS? They provide additional information on how services, items, or procedures are paid in the OPPS/ASC payment systems. What do ASC status indicators specify? They identify how a procedure, item, or service is paid or not paid under the OPPS. What do ASC payment indicators define? They describe how the ASC payment for a specific procedure, item, or service is determined under the ASC payment system. What does the wheelchair symbol in HCPCS Level II denote? It indicates items that may be eligible for payment from CMS, such as durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). What do alternative drug names in the HCPCS Table of Drugs indicate? Alternative names for drugs, such as generic versus brand names, listed beside the drug administration code. What does the NDC symbol in blue letters signify? It highlights alternative drug names eligible for payment under Medicare Part B. What does the MIPS symbol indicate?