What are some common Healthcare Common Procedure Coding System (HCPC) codes?

Common HCPCS Codes for Medical Billing

The most common HCPCS codes include CPT codes 99204 for new patient office visits, 99214 for established patient visits, and procedure-specific codes like 94621 for complex pulmonary testing and 36600 for arterial puncture. 1

Understanding HCPCS Coding System

HCPCS (Healthcare Common Procedure Coding System) is a standardized coding system used primarily for billing and reimbursement of healthcare services in the United States. The system consists of:

• Level I: Current Procedural Terminology (CPT) codes developed by the American Medical Association
• Level II: National codes developed by CMS for services not covered by CPT codes

Common Evaluation and Management (E&M) Codes

These are among the most frequently used HCPCS codes:

• New Patient Office Visits:

  • 99201-99205 (varying levels of complexity)
  • 99204: For comprehensive visits requiring 45-59 minutes with moderate complexity decision-making 1

• Established Patient Office Visits:

  • 99211-99215 (varying levels of complexity)
  • 99214: For visits requiring 25 minutes face-to-face time with moderate complexity 1

Common Procedure-Specific Codes

Pulmonary Testing Codes

• 94620: Simple stress pulmonary test 2
• 94621: Complex stress pulmonary test (requires physician presence) 2
• 94681: Oxygen uptake and expired gas analysis 2

Cardiac Testing Codes

• 93015: Cardiac stress test 2
• 93018: Cardiac measurements during pulmonary test 2

Laboratory and Diagnostic Procedures

• 36600: Arterial puncture 2
• 36620: Arterial catheterization 2
• 82803: Blood gas analyzer for blood processing 2

Preventive Medicine Services

• 99396: Preventive medicine service for established patients aged 40-64 years 1

Proper Coding Practices

Modifier Usage

• Modifier 25: Used when a significant, separately identifiable E&M service is performed on the same day as another procedure or service 1
  • Example: When billing both preventive (99396) and problem-oriented services on the same day

Documentation Requirements

• Documentation must support the level of service billed
• For new patients, all three key components (history, examination, medical decision making) must meet the specified level 1
• For established patients, only two of the three key components need to meet the specified level 1

Common Coding Pitfalls to Avoid

• Insufficient documentation
• Incorrect modifier usage
• Undercoding (not capturing the full complexity of services provided)
• Failure to document time when using time as the determining factor for code selection

Insulin Delivery-Related Codes

While not strictly HCPCS codes, it's worth noting that insulin delivery has specific coding considerations:

• Insulin pen needles (4-6mm) are recommended to minimize accidental intramuscular injection risk 2
• Safety-engineered devices should be used by healthcare providers to minimize needlestick injuries 2

Cardiac Arrest Coding

For reference, cardiac arrest has specific coding designations:

• ICD-10 code 427.5: Cardiac arrest
• ICD-9 code 99.60: Cardiopulmonary resuscitation not otherwise specified
• ICD-9 code 99.63: Closed chest cardiac massage
• DRG 129: Cardiac arrest, unexplained 2

Importance of Proper Coding

Accurate coding is essential for:

• Proper reimbursement
• Tracking epidemiological data
• Quality metrics and resource allocation
• Avoiding audit issues with payers

Remember that coding should always reflect the actual services provided and be supported by thorough documentation in the medical record 3.