Assignment: Common Procedure Coding System

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Assignment: Common Procedure Coding System

Assignment: Common Procedure Coding System

Explain the Healthcare Common Procedure Coding System (HCPCS). Why is HCPCS important to the coding world? What can be found when using HCPCS?

Next, code for the following scenario using Encoder Pro:

A woman has come into the physician’s office for a routine pap smear. From her past appointments, there has always been a screening completed for cervical or vaginal cancer as well as a pelvic and clinical breast examination.

Please code for the HCPCS procedure. Also, list your steps for finding the code.

Your complete assignment should be a minimum of two pages in length. Outside sources are not a requirement for this assignment.


1.Procedure code descriptions contain diagnostic information.



2.NOS stands for not otherwise specified.



3.Root operation is a device that remains in the body after the completion of a procedure.



4.The index is the ending point when selecting the code.



5.The character positioning on the table has little meaning.



6.NEC stands for not elsewhere classified.



7.The character meaning for M is the body system, the bursae, and ligaments.



This variable can be found in the following documents: 
Transporter (Fee-for-Service) 
Medical Equipment That Is Long Lasting (Fee-for-Service) 
Agency for Health Care at Home (Fee-for-Service) 
Hospice is non-profit organization that (Fee-for-Service) 
irritable (Fee-for-Service) 
Outpatient treatment (Fee-for-Service) 
Nursing Home with Skilled Staff (Fee-for-Service)






The Healthcare Common Procedure Coding System (HCPCS) is set of codes that describe procedures, supplies, products, and services that Medicare beneficiaries and people with commercial health insurance can get. 
As explained below, the codes are separated into three levels or groups (in COMMENT).


This variable can reflect the precise case-mix grouping that Medicare utilized to pay for skilled nursing facility (SNF), home health, or inpatient rehabilitation facility (IRF) services in the Institutional Encounter Revenue Center Files (see Note in COMMENT section below).


Level comments


The American Medical Association’s Current Procedural Terminology, Fourth Edition has copyrighted the codes and descriptions (CPT-4). 
Physician and non-physician services are represented by these 5-position numeric codes.


**** **** **** **** **** **** **** **** **** **** *


According to the CMS/AMA agreement, CPT-4 codes with both long and short explanations must be utilized. 
Any other usage is infringing on the AMA’s copyright.


Level Two


The American Dental Association’s Current Dental Terminology, Fifth Edition includes copyrighted codes and descriptors (CDT-5). 
The series is made up of 5-position alpha-numeric codes. 
The alpha-numeric editorial panel approves and maintains all additional level II codes and descriptors (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). 
These are 5-position alphanumeric codes that represent products and non-physician services not covered by the level codes.


Level 3:


Medicare carriers (formerly known as Medicare Administrative Contractors; MACs) produce codes and descriptions for usage at the local (MAC) level. 
These are 5-position alpha-numeric codes in the W, X, Y, or series that reflect physician and non-physician services not covered by level or II codes.


**** **** **** **** **** **** **** **** **** **** *


This field could contain information about how Medicare paid for SNF, home health, or IRF services using case-mix grouping. 
Health Insurance Prospective Payment System (HIPPS) codes are another name for these classifications.


If the revenue center code (REV CNTR) matches 0022 for SNF care, 0023 for home health, or 0024 for IRF care, this field will contain HIPPS code.


Please note the revenue center APC/HIPPS code variable (REV CNTR APC HIPPS CD) for home health claims.
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