Description of Healthcare Common Procedure Coding System (HCPCS)

20 - Description of Healthcare Common Procedure Coding System (HCPCS) (Rev. 10320, Issued: 08-28-2020, Effective: 12-01-2020, Implementation: 12-01-2020) The HCPCS has been adopted as the code set for use in Health Insurance Portability and Accountability Act (HIPAA) transactions, for reporting outpatient procedures, items, and services. The HCPCS originated from the American Medical Association’s (AMA) “Physicians’ Current Procedural Terminology, Fourth Edition” (CPT-4). It includes two levels of codes and modifiers. Level I contains only the AMA’s CPT-4 codes. This level consists of all numeric codes. Level II contains alpha-numeric codes primarily for items and nonphysician services not included in CPT-4, e.g., ambulance, DME, orthotics, and prosthetics. These are alpha-numeric codes maintained by CMS. The CMS monitors the system to ensure uniformity.