Who is responsible for updating hcpcs codes
If this article seems confusing with all its acronyms and its descriptions of the healthcare reimbursement system, it is because it is.Medical billing and medical coding is a specialized profession that entails a thorough understanding of ever-changing issues and regulations.codes, and CMS follows the guidelines promulgated through the National Correct Coding Initiative (NCCI).CMS annually publishes the NCCI Policy Manual, and issues quarterly updates.
Medical billers with the proper training understand that HCPCS Level I codes are used to bill Medicare, a government health insurance program that covers 48 million Americans, who make up a large percentage of any healthcare facility’s patient population.Professional medical billers and certified medical coders are trained to understand the difference between CPT and HCPCS.While CPT codes are used to describe medical services provided to patients, HCPCS codes are used specifically to bill Medicare.Medical billers ensure that all healthcare claims are compliant with HIPPA through the accurate application of medical codes based on the documentation in the patient’s medical record, and based on the standards established by HCPCS.The federal Centers for Medicare and Medicaid Services (CMS) oversees the definition and use of HCPCS codes. Level I codes are commonly referred to as CPT codes because they belong to the Current Procedural Terminology (CPT) administered by the American Medical Association (AMA).
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If a Medicare claim contains codes that are governed by MUEs, one of the codes will be denied payment based on the NCCI.