2016 HCPCS Coding Corrections

by | Last updated Jun 5, 2023 | Published on Feb 25, 2016 | Resources, Medical Coding News (A) | 0 comments

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The Centers for Medicare and Medicaid Services (CMS) has released few corrections to the 2016 HCPCS Level II code set. Though the updates were released late, the changes are effective from Jan 1, 2016. HCPCS was developed by the Centers for Medicare and Medicaid (CMS) for the same reasons that the AMA developed CPT: for reporting medical procedures and services. Medical coding specialists use HCPCS codes to report medical procedures to Medicare, Medicaid, and several other third-party payers. The code set is divided into two levels. While level one is identical to CPT, level II codes are designed to represent non-physician services like ambulance rides, wheelchairs, walkers, durable medical equipment, and other medical services that don’t fit readily into Level I. Like level I, level II codes are five characters long, but these codes are alphanumeric, with a letter forming the first character of the code. Recent Corrections to the HCPCS Level II code set Replaced code

  • G0298 replaced with G0475
  • G0472 Add pricing indicator 21

Newly added codes Several new codes were added to the list for drug testing, which include:

  • G0477 – Drug test presump optical
  • G0479 – Drug test presump not opt
  • G0480 – Drug test def 1-7 classes
  • G0481 – Drug test def 8-14 classes
  • G0482 – Drug test def 15-21 classes
  • G0483 – Drug test def 22+ classes

Deleted codes Codes that are deleted include G6030, G6031, G6032, G6034, G6035, G6036, G6037, G6038, G6039, G6040, G6041, G6042, G6043, G6044, G6045, G6046, G6047, G6048, G6049, G6050, G6051, G6052, G6053, G6054, G6055, G6056, G6057, G6058 Other changes

  • J0571 – Change Long Desc – Buprenorphine, oral, 1 mg
  • Q9975 – Change Long Desc – Injection, factor viii fc fusion protein (recombinant), per iu

Medical coders providing professional medical billing and coding services keep abreast with such coding updates, as they are aware of the fact that a single error in medical claims will lead to claim denials or delay, resulting in late reimbursement or lost revenue for physicians.

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