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Reporting the Right HCPCS Codes For Devices

Reporting the Right HCPCS Codes For Devices

Published by: Melissa Clark, CCS-P on September 15, 2005

Reporting the Right HCPCS Codes For Devices

When doing medical billing it is very important to report the correct HCPCS codes. Failure to do so could result in a returned claim or partial payment. Both of these outcomes are unacceptable for medical billing companies. Businesses cannot run without begin paid.

HCPCS stands for Healthcare Common Procedure Coding System. These codes, similar to Current Procedural Terminology codes, report what medical devices are used for health care when doing medical billing. If the hospital submits a claim that supports a device code or two, that hospital is required to report at least one of the HCPCS codes on a medical billing claim. If a HCPCS code is not reported, the claim may be returned back to the medical billing company with no payment.

There is one situation when this principal does not apply to medical billing. If a procedure happens to be interrupted prior to using the device, the medical biller can report that CPT code without a HCPCS code. In this case they will need to clarify the reason the HCPCS code is missing with a modifier. Three modifiers are allowed for medical billing in this instance: modifier 52 which means reduced services, Modifier 73 which means discontinued outpatient procedure prior to anesthesia administration, or modifier 74 which means after anesthesia administration.

Professional medical billing companies are aware of these procedural practices. They keep up to date on HCPCS codes and know the correct uses for the modifiers. It is beneficial for health care practices to use a medical billing company because it will reduce returned claims and the research time required to process each claim.

It is very important to report the correct HCPCS device codes in order to provide an accurate claim that will not be returned to a medical billing company.

Published by: on September 15, 2005

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