HCPCS Coding For Beginners - Book Introduction

Contempo Coding

15 Jun 202122:37

EducationalLearning

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TLDRIn this informative video, Victoria, a medical coding expert, provides an in-depth overview of the HICPICs book, also known as the Healthcare Common Procedure Coding System Level 2. She explains its importance in medical coding, particularly for coding medications, ambulance services, durable medical equipment, and insurance-specific codes. Victoria also discusses the book's role in certification exams like the CPC, highlighting that it comprises only a small portion of the exam content. She further explores different editions of the HICPICs book, their features, and how they can be utilized effectively in various medical coding scenarios.

Takeaways

📚 The 'Hickpix' book, officially known as the HCPCS (Healthcare Common Procedure Coding System) Level 2, is often overlooked in medical coding curriculums.
🧪 It covers areas like drugs, medications, ambulance services, durable medical equipment, and insurance-specific codes.
📈 The CPC exam includes only a small number of questions on HCPCS Level 2 codes, with five specific questions in total.
📚 Different publishers produce the HCPCS book, and specific editions are permitted for AHIMA exams.
📊 The use of the HCPCS book varies among organizations; some may share one book among coders due to infrequent use.
💊 The book contains drug codes, modifiers not found in the CPT book, abbreviations, and acronyms, as well as appendices with useful information.
📝 Some editions have more blank spaces for note-taking, which can be beneficial for those preparing for exams or looking to annotate their code books.
🔍 The HCPCS book uses icons and color-coding to indicate coverage, Medicare status, and other important information for coding professionals.
💻 Tools like Codify can replace the need for physical HCPCS books, as they allow for searching specific codes within an encoder system.
🩺 Certain medical fields, such as durable medical equipment or ambulance services, rely heavily on HCPCS codes.
📝 The HCPCS book is intuitive for those familiar with ICD-10 and CPT, and its coding is generally straightforward.

Q & A

What is the HCPCS book and why is it sometimes referred to as the 'Hickpix' book?
-The HCPCS book, often humorously called the 'Hickpix' book, stands for the Healthcare Common Procedure Coding System. It is a coding system used in the medical field for procedures and services not covered by CPT codes. It includes codes for drugs, durable medical equipment, ambulance services, and insurance-specific codes.
What is the difference between Level 1 and Level 2 of HCPCS coding?
-Level 1 of HCPCS coding is represented by CPT codes, which are used for reporting medical, surgical, and diagnostic procedures. Level 2, on the other hand, includes codes for drugs, biologicals, and other items and services that do not have a CPT code.
What types of services or items are typically found in the HCPCS Level 2 book?
-The HCPCS Level 2 book contains codes for drugs, medications, ambulance services, durable medical equipment (like casts and crutches), and insurance-specific codes for services like annual exams under certain insurance plans.
How is the HCPCS book structured?
-The HCPCS book is structured with a table of contents listing codes alphabetically, an introduction, and various appendices. It includes a table of drugs, modifiers, abbreviations and acronyms, and sections for different types of services and items like DME, procedures, and medications.
What is the significance of the different colors and icons used in the HCPCS book?
-Different colors and icons in the HCPCS book indicate various payment and coverage statuses. For example, green indicates special coverage instructions, pink/red (non-covered by Medicare), yellow (carrier discretion), and blue (Medicare-specific codes). There are also indicators for quantity alerts, age edits, and OPPS status indicators.
How often are HCPCS codes updated and where can one find the most recent changes?
-HCPCS codes are updated annually. The most recent changes can be found in the appendices of the HCPCS book, specifically in the section titled 'HCPCS Changes for [year]'.
What is the role of the Coding Clinic in HCPCS coding?
-The Coding Clinic provides official guidance on HCPCS coding. It is a paid subscription published by the American Hospital Association and contains advice on coding practices, including specific code application and interpretation.
How can one determine the correct unit amount to bill for a medication in the HCPCS book?
-The correct unit amount to bill for a medication is determined by the dosage administered and the defined billing unit within the HCPCS code description. For example, if a code is defined per 10 milligrams and 40 milligrams were administered, the biller would calculate and bill for four units.
What are some examples of services or items that might be found in the 'Durable Medical Equipment' section of the HCPCS book?
-In the 'Durable Medical Equipment' section of the HCPCS book, one might find codes for items like walkers, canes, crutches, orthopedic footwear, and wheelchair accessories.
How can the HCPCS book assist someone preparing for the CPC exam?
-While the HCPCS book is not heavily featured in the CPC exam, it can help with understanding the coding of medications, ambulance services, and other items and services not covered by CPT codes. Familiarity with the HCPCS book can contribute to a comprehensive understanding of medical coding, which may enhance exam preparation.
What is the purpose of the note sections in the HCPCS book?
-The note sections in the HCPCS book provide space for users to write additional notes, such as abbreviations, reminders, or specific coding guidance. This can be particularly helpful for users who wish to personalize their coding resources and have quick references during coding tasks or exams.

Outlines

00:00

📚 Introduction to the HICPIC Book

This paragraph introduces the HICPIC (Healthcare Common Procedure Coding System) book, which is often overlooked in medical coding curriculums. Victoria, a medical coding educator, explains that while the book is not extensively covered, it is crucial for understanding certain coding aspects like drugs, ambulance services, durable medical equipment, and insurance-specific codes. She emphasizes the book's importance and provides an overview of its content, promising demonstrations to follow.

05:00

📔 HICPIC Book's Role and Structure

Victoria delves into the specifics of the HICPIC book, discussing its role in coding for medical procedures and the various types of codes it contains, such as drug codes, modifiers, and insurance-specific codes. She mentions the book's different editions and how they vary, highlighting the Optum 360 version's features, such as appendices and updated changes for 2021. Victoria also touches on the book's intuitive nature for those familiar with ICD-10 and CPT coding systems.

10:01

💊 Detailed Look at HICPIC Codes for Medications and Durable Medical Equipment

In this section, Victoria provides a detailed examination of the HICPIC book's sections on medications and durable medical equipment (DME). She explains the coding for various medical supplies, such as skin replacements and dialysis services, and emphasizes the importance of accurate dosage calculations for drug codes. Victoria also discusses the use of G-codes for Medicare-specific services and the significance of understanding these codes for medical coders.

15:02

📋Modifiers, Abbreviations, and Additional HICPIC Resources

Victoria explores the HICPIC book's appendices, which include modifiers not found in the CPT book, abbreviations, and acronyms. She highlights the book's usefulness for note-taking during exams and the inclusion of the Medicare Internet Only Manual and HICPIC changes for 2021. The paragraph also covers the different types of service codes, such as ASC payment indicators and CCI edits, providing insights into the comprehensive resources available in the HICPIC book.

20:03

🔍 Demonstration of HICPIC Code Lookup and Application

Victoria concludes with a practical demonstration of how to use the HICPIC book for code lookup, using the example of coding for a prosthetic eye. She guides the viewer through the alphabetic index, identifies the correct code (V2623) for a plastic custom prosthetic eye, and reinforces the importance of accurate documentation and code selection. The demonstration underscores the book's value in medical coding practice.

Mindmap

Keywords

💡HCPCS

The Healthcare Common Procedure Coding System (HCPCS) is a level 2 coding system used primarily for reporting medical services and procedures not covered by the CPT codes. In the video, the speaker explains that while HCPCS is not extensively covered in many medical coding curriculums, it is essential for coding certain services like medications, ambulance services, and durable medical equipment.

💡CPT

CPT (Current Procedural Terminology) is a coding system used in the healthcare industry primarily for reporting medical procedures and services performed by healthcare providers. It is technically considered HCPCS level 1. The video explains that CPT codes are more commonly taught in medical coding curriculums compared to HCPCS level 2 codes.

💡Medical Coding

Medical coding is the process of converting healthcare services and diagnoses into standardized codes for insurance billing, reimbursement, and data analysis purposes. The video emphasizes the importance of understanding both CPT and HCPCS coding systems in a medical coding career, despite the limited coverage of HCPCS in education.

💡Certification Exams

Certification exams, such as the CPC (Certified Professional Coder) exam, are tests that healthcare professionals must pass to demonstrate their competency in medical coding. The video provides insight into the content of the CPC exam, including the minimal emphasis on HCPCS level 2 codes.

💡Coding Manuals

Coding manuals, such as the HCPCS book and CPT book, are reference materials that provide detailed information on coding systems, codes, and guidelines. The video discusses the different editions and versions of these manuals, their uses, and how they can be supplemented with notes for medical coding exams.

💡Modifiers

Modifiers are alphanumeric codes added to a primary code to provide additional information about a service or procedure. In the context of the video, the speaker explains that while some modifiers are found in the CPT book, others are specific to HCPCS and can be found in the HCPCS manual.

💡Durable Medical Equipment (DME)

Durable Medical Equipment (DME) refers to medical equipment that can be used repeatedly and is primarily used in a home setting. The video emphasizes that DME coding often involves HCPCS level 2 codes, as these items require specific codes for insurance billing.

💡Ambulance Services

Ambulance services are pre-hospital emergency medical services provided by specially equipped and staffed vehicles. The video explains that these services have specific HCPCS level 2 codes that must be used for billing purposes.

💡Medicare

Medicare is a federal health insurance program in the United States that provides coverage for individuals aged 65 and over, as well as certain younger individuals with disabilities. The video discusses Medicare-specific codes, such as G-codes, which are used for services like vaccinations and cancer screenings.

💡Coding Clinic

Coding Clinic is a publication that provides official guidance on coding issues. It is published by the American Hospital Association and is a paid subscription service. The video mentions that the Coding Clinic offers official guidance on specific coding scenarios, which can be referenced in the HCPCS manual.

💡Appendices

Appendices in coding manuals, like the HCPCS book, contain supplementary information that supports the main content, such as payment status indicators, modifiers, and updated codes. The video highlights the importance of the appendices for staying current with coding changes and for exam preparation.

Highlights

The HICPICs book, often referred to as the 'Hickpix' book, is less emphasized in medical coding education and some curriculums don't cover it at all.

The HICPICs book is the Healthcare Common Procedure Coding System and is actually HICPIC Level 2, while CPT is technically HICPIC Level 1.

The HICPICs book is primarily used for coding drugs, medications, ambulance services, durable medical equipment, and insurance-specific codes.

Different publishers produce the HICPICs book, and for CPC and AHIMA exams, specific editions are allowed or any version can be used.

The HICPICs book may not be frequently used in some organizations, leading to shared usage or no purchase at all, with tools like Codify being used instead.

The HICPICs book is more commonly used in organizations dealing with durable medical equipment (DME) or ambulance billing.

The HICPICs book contains a table of drugs, modifiers not found in the CPT book, abbreviations, and acronyms, among other resources.

The HICPICs book includes information on the Quality Payment Program and has a section for note-taking with blank pages.

The alphabetic index in the HICPICs book allows for easy lookup of codes, with sections for medical and surgical supplies, outpatient PPS, and procedures.

The HICPICs book contains specific codes for services like ambulance, durable medical equipment, and professional services with insurance-specific codes.

Medicare-specific G-codes are found in the HICPICs book, which are often used for immunization administration and other services.

The HICPICs book provides guidance on billing units for medications, requiring attention to dosages and calculation of units billed.

Modifiers not listed in the CPT book can be found in the HICPICs manual, with an entire appendix dedicated to them.

The HICPICs book includes a table of drugs and biologicals for easy reference and calculation of units for billing.

The HICPICs book contains appendices with updated codes, payment status indicators, ASC payment indicators, and more.

Different editions of the HICPICs book may vary in content, size, and appendices, with some including anatomical illustrations and more detailed information.

The HICPICs book serves as a valuable resource for medical coders, providing a comprehensive guide to procedure coding beyond CPT codes.

Transcripts

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Medical Coding HCPCS Level 2 Victoria Educator Coding Certification Healthcare Billing Drug Code Reference Medical Equipment Codes Ambulance Billing Coding Exam Prep CPT vs HICPCS