The HCPCS code set is a coding system for specific products, supplies, and services that patients receive in the delivery of their care.
Annual updates to HCPCS codes are released on the CMS HCPCS website for use effective January 1 of each year, and annual HCPCS code books are published as a code reference. Interim updates for temporary codes are also found on the CMS HCPCS website.
The HCPCS index is arranged alphabetically, as is the Table of Drugs included in HCPCS code books. The main text is made up of sections of codes arranged numerically according to their initial letter, from Section A through Section V.
HCPCS modifiers are either two letters or a letter plus a number. Modifiers are used to clarify a HCPCS code by making it more specific.
Correct HCPCS coding follows the same general guidelines as ICD-9-CM and CPT coding. Begin by locating the item to be coded in the index (or the Table of Drugs), and then verify the probable code in the main sections. Assign appropriate modifiers.
Medicare billing rules for specific HCPCS codes are shown by references in the main sections next to the codes. The reference MCM means that a billing rule for that code’s use must be looked up the appendix of the HCPCS code book containing the Medicare Carriers Manual or by checking the original source. The reference CIM likewise means that a billing rule must be checked in the Coverage Issues Manual.
