Overview on Healthcare Common Procedure Coding System
Before we compare HCPCS vs. CPT, let’s look at HCPCS or Healthcare Common Procedure Coding System.
HCPCS talks about healthcare procedure codes to describe basic healthcare services or items. It aims to provide a standardized coding system for healthcare professionals using the CPT codes, and it has two key components: Level I and Level II.
Level I is a coding system published by the American Medical Association or AMA. Level I HCPCS (CPT-4) has codes and terms to identify medical services or procedures physicians perform.
While Level II HCPCS refers to products, services, and supplies that aren’t included in the CPT-4. Some examples are DMEPOS or durable medical equipment, prosthetics, orthotics, and supplies. The Level II of HCPCS reports non-physician services together with DMEPOS.
Understanding CPT coding terminology
Before discussing the difference between HCPCS and CPT codes, it’s essential to understand both. So to begin, let’s take a look at CPT.
CPT® means Current Procedural Terminology, which are codes that healthcare professionals use to standardize medical procedures and ensure accurate billing systems and reporting. CPT codes are used worldwide, and are developed, maintained, and copyrighted by AMA or the American Medical Association. CPT codes have three different categories:
- Category I: These codes describe medical procedures and services that are widely performed within the healthcare industry.
- Category II: These codes are used to track performance and quality indicators.
- Category III: These codes track emerging technologies, procedures, and services that are not yet widely performed within the healthcare industry.
To summarize, CPT codes refer to services like surgeries, radiology, evaluation and management, anesthesiology, and more.
Difference between CPT and HCPCS
Here’s a complete breakdown of CPT codes vs HCPC in a table format, so you can better visualize the differences between these coding systems:
These are the key differences between CPT vs HCPCS codes. In summary, CPT and HCPCS codes aim to standardize and create a uniform language for the healthcare industry, ensuring that compliance is adhered to and medical practitioners can receive reimbursement for their services.
At first, HCPCS codes vs CPT can be overwhelming. But to sum it up, HCPCS refers to codes used for billing, insurance, and more provided for the patients. At the same time, CPT codes describe the medical procedures or services done for the patients.
Even if they’re different, they can work hand in hand to ensure that the healthcare industry can strengthen compliance and provide the best quality care for patients.
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