Hcpcs le - Study guides, Class notes & Summaries

HCPCS Level 2 ch. 13 Latest Update Graded A+ **DMERC** A designated entity responsible for managing Medicare claims related to durable medical equipment (DME) within specific regions or states. **Parenteral** The administration of substances through routes other than the digestive tract, such as intravenous, intramuscular, or subcutaneous. **Not Otherwise Specified (NOS)** Indicates that specific details are unavailable from the physician's documentation. **Orthotic** Devic...

HCPCS Level II - also called national code used to describe common medical services/services. 5 characters in length, and they begin w/ letters A-V followed with 4 numbers. HCPCS level II used to identify services performed by: - Physician and non physician providers. Ambulance companies Durable medical equipment companies Durable Medical Equipment (DME) - Equipment that can withstand repeated use. Primarily used to serve a medical purpose. Used in the patient's home(or assisted living ...

Alcohol and Drug Abuse codes - H0001-H2037 Categories of temporary codes: C codes - identify items that may qualify for transitional pass through payments under OPPS Categories of temporary codes: G codes - identify professional health care procedures and services that do not have codes identified in CPT Categories of temporary codes: H codes - reported to state Medicaid agencies as mandated by state law to identify mental health services. Categories of temporary codes: K codes - reported...

Durable (can withstand repeated use) -Used for a medical reason -Not usually useful to someone who isn't sick or injured -Used in your home -Generally has an expected lifetime of at least 3 years - Answer-DME must be prescribed by a physician and must meet these criteria: 1. Review the patient record to determine the procedures performed or services provided. 2. Locate the main term in the HCPCS Level II index. 3. Identify the code next to the main term in the HCPCS Level II index. Ther...

"OPT OUT" physician or practitioner emergency or urgent service. - GJ Acute or chronic active / corrective treatment (effective October 1, 2004) - AT Advance Beneficiary Notification on file. - GA Ambulatory surgical center (ASC) facility charges. This modifier is used only by the ASC for identifying the facility charge. It should not be reported by the physician when reporting the physician's professional service rendered in an ASC. - SG Anesthesia services personally furnished by an a...

An advance beneficiary notice (ABN) - a waiver signed by the patient acknowledging that because medical necessity for a procedure, service, or supply cannot be established (e.g., due to the nature of the patient's condition, injury, or illness), the patient accepts responsibility for reimbursing the provider or DMEPOS dealer for costs associated with the procedure, service, or supply. C codes - permit implementation of section 201 of the Balanced Budget Refinement Act of 1999, and they ide...

HCPCS Level II Questions and Answers 100% Pass **What is the purpose of C codes under the Medicare Outpatient Prospective Payment System (OPPS)?** Required for use by hospitals under OPPS; other facilities may choose to report them. **How are G codes utilized?** Assigned nationally by CMS to identify healthcare procedures and services that may lack assigned CPT codes. **What is the function of H codes?** Establish unique temporary codes for mental health services as mandated by s...

HCPCS level II (2024 / 2025) Actual Questions with Verified Answers, 100% Guarantee Pass

HCPCS Level II Exam Questions and Answers 100% Solved CPT® codes don't completely report all of the services provided to patients. Services provided by some healthcare providers are not covered under the CPT coding system. Many of the supplies used in patient care (e.g., drugs and durable medical equipment) are also not reported with CPT codes. Since providers, naturally, want to be reimbursed for professional services in specialized areas and for supplies, durable medical equipment...

The ASC status and payment indicators provide additional information about how the services/items/procedures denoted are paid in the OPPS/ASC payment systems. - Answer ASC/OPPS Status Indicators - Answer The ASC status indicators identify how a specific procedure, item, or service is paid or not paid under the OPPS. ASC Payment Indicators - Answer The ASC payment indicators identify how the ASC payment for a specific procedure, item, or service is derived under the ASC payment system.