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2016 HCPCS Level II Standard Edition - E-Book

2016 HCPCS Level II Standard Edition - E-Book

Carol J. Buck

(2016)

Additional Information

Book Details

Abstract

For quick, accurate, and efficient coding, pick the market-leading HCPCS reference! From coding expert Carol J. Buck, 2016 HCPCS Level II, Standard Edition provides an easy-to-use guide to the latest Healthcare Common Procedure Coding System codes. It helps you locate specific codes, comply with coding regulations, optimize reimbursement, report patient data, code Medicare cases, and more. With this standard edition, you can focus on the basics of HCPCS coding — so you save money!

  • At-a-glance code listings and distinctive symbols identify all new, revised, and deleted codes for 2016.
  • Drug code annotations identify brand-name drugs as well as drugs that appear on the National Drug Class (NDC) directory and other Food and Drug Administration (FDA) approved drugs.
  • Information on coverage provides alerts when codes have special instructions, are not valid or covered by Medicare, or may be paid at the carrier’s discretion.
  • Jurisdiction symbols show the appropriate contractor to be billed for suppliers submitting claims to Medicare contractors, Part B carriers, and Medicare administrative contractors submitting for DMEPOS services provided.
  • Color-coded Table of Drugs makes it easier to find specific drug information.
  • Codingupdates.com website includes quarterly updates to HCPCS codes and content, and the opportunity to sign up for e-mail notifications of the newest updates.
  • UPDATED 2016 official code set ensures compliance with current HCPCS standards, for fast and accurate coding.

Table of Contents

Section Title Page Action Price
Front Cover Cover
2016 HCPCS Level II STANDARD EDITION i
Copyright Page ii
DEVELOPMENT OF THIS EDITION iii
DEDICATION iv
TABLE OF CONTENTS v
INTRODUCTION vii
GUIDE TO USING THE 2016 HCPCS LEVEL II CODES viii
SYMBOLS AND CONVENTIONS ix
2016 HCPCS UPDATES xi
2016 INDEX 1
2016 TABLE OF DRUGS 41
2016: HCPCS LEVEL II NATIONAL CODES 91
LEVEL II NATIONAL MODIFIERS 92
Ambulance Modifiers 101
TRANSPORT SERVICES INCLUDING AMBULANCE (A0000‑A0999) 101
MEDICAL AND SURGICAL SUPPLIES (A4000‑A6513) 102
Vascular Catheters 105
Incontinence Appliances and Care Supplies 105
External Urinary Supplies 106
Ostomy Supplies 107
Miscellaneous Supplies 109
Supplies for Respiratory and Oxygen Equipment 111
Supplies for Other Durable Medical Equipment 112
Supplies for Radiological Procedures 112
Miscellaneous Supplies 112
Supplies for Dialysis 112
Additional Ostomy Supplies 114
Additional Incontinence Appliances/Supplies 115
Supplies for Either Incontinence or Ostomy Appliances 115
Diabetic Shoes, Fitting, and Modifications 115
Dressings 116
GRADIENT COMPRESSION STOCKINGS (A6530‑A6549) 121
WOUND CARE (A6550) 122
RESPIRATORY DURABLE MEDICAL EQUIPMENT, INEXPENSIVE AND ROUTINELY PURCHASED (A7000‑A7509) 122
HELMETS (A8000‑A8004) 123
ADMINISTRATIVE, MISCELLANEOUS, AND INVESTIGATIONAL (A9000‑A9999) 124
Supplies for Radiology Procedures (Radiopharmaceuticals) 124
Miscellaneous Service Component 126
ENTERAL AND PARENTERAL THERAPY (B4000‑B9999) 127
Enteral Formulae and Enteral Medical Supplies 127
Parenteral Nutritional Solutions and Supplies 128
Enteral and Parenteral Pumps 129
CMS HOSPITAL OUTPATIENT PAYMENT SYSTEM (C1000‑C9999) 130
DURABLE MEDICAL EQUIPMENT (E0100‑E1841) 140
Canes 140
Crutches 140
Walkers 140
Attachments 141
Commodes 141
Decubitus Care Equipment 141
Heat/Cold Application 142
Bath and Toilet Aids 142
Hospital Beds and Accessories 143
Oxygen and Related Respiratory Equipment 144
IPPB Machines 146
Humidifiers/Nebulizers/Compressors for Use with Oxygen IPPB Equipment 146
Suction Pump/Room Vaporizers 146
Monitoring Equipment 146
Pacemaker Monitor 146
Patient Lifts 147
Pneumatic Compressor and Appliances 147
Ultraviolet Cabinet 148
Safety Equipment 148
Restraints 148
Transcutaneous and/or Neuromuscular Electrical Nerve Stimulators (TENS) 148
Infusion Supplies 149
Traction Equipment: All Types and Cervical 149
Traction: Overdoor 150
Traction: Extremity 150
Traction: Pelvic 150
Trapeze Equipment, Fracture Frame, and Other Orthopedic Devices 150
Wheelchair Accessories 150
Rollabout Chair and Transfer System 152
Wheelchair: Fully Reclining 152
Wheelchair: Semi‑reclining 153
Wheelchair: Standard 153
Wheelchair: Amputee 153
Wheelchair: Special Size 153
Wheelchair: Lightweight 154
Wheelchair: Heavy Duty 154
Whirlpool Equipment 155
Additional Oxygen Related Equipment 155
Artificial Kidney Machines and Accessories 155
Jaw Motion Rehabilitation System and Accessories 156
Other Orthopedic Devices 156
MISCELLANEOUS (E1902‑E2120) 157
Wheelchair Assessories 157
Negative Pressure 160
Speech Device 160
Wheelchair, Cushion and Protection 160
SKIN PROTECTION, WHEELCHAIR (E2622‑E2625) 161
ARM SUPPORT (E2626‑E2633) 161
GAIT TRAINER (E8000‑E8002) 161
TEMPORARY PROCEDURES/PROFESSIONAL SERVICES (G0000‑G9999) 162
Administration, Vaccine 162
Semen Analysis 162
Screening, Cervical 162
Screening, Prostate 162
Screening, Colorectal 162
Training Services, Diabetes 163
Screening, Glaucoma 163
Screening, Colorectal, Other 163
Screening, Cytopathology 163
Trimming, Nail 163
Service, Nursing and OT 164
Study, SEXA 164
Screening, Cytopathology, Other 164
Services, Allied Health 164
Wound Closure 165
Team Conference 165
Therapy, Activity 165
Physician Services 166
Destruction 166
Mammography 166
Imaging, PET 167
Therapeutic Procedures 167
Physician Service, Diabetic 167
Foot Care 167
Demonstration, INR 167
Imaging, PET 168
SNCT 168
Dialysis, Emergency 168
Injection, Arthrography 168
Removal, Cerumen 168
Placement, Occlusive Device 168
Therapy, Nutrition 168
Blinded Procedure 169
Therapy, Hyperbaric Oxygen 169
Angiography 169
Diagnostic 169
Stimulation, Electrical 169
Angiography, Arthroscopy 169
Procedure, Non‑Covered 169
Therapy, Electromagnetic 169
Other 169
Services, Pulmonary Surgery 170
Laboratory 170
Therapy, Electromagnetic 170
Fee, Pharmacy 170
Hospice 170
Radiosurgery, Robotic 170
Islet Cell 170
Aspiration, Bone Marrow 171
Mapping, Vessel 171
Services, Observation and ED 171
Ultrasound, AAA 172
Team, Trauma Response 172
Assessment/Intervention 172
Home Sleep Study Test 173
Examination, Initial Medicare 173
Electrocardiogram 173
Telehealth 173
Services, Social, Psychological 173
Treatment, Bone 174
Pathology, Surgical 174
Educational Services, Rehabilitation, Telehealth, and Miscellaneous 174
Tositumomab 177
Guidance 177
Treatment, Radiation 177
Drugs 178
Documentation 178
Influenza A (H1N1) and Warfarin Responsiveness Testing 196
BEHAVIORAL HEALTH AND/OR SUBSTANCE ABUSE TREATMENT SERVICES (H0001‑H9999) 214
DRUGS OTHER THAN CHEMOTHERAPY (J0100‑J8999) 216
Miscellaneous Drugs and Solutions 232
Immunosuppressive Drugs (Includes Non‑injectibles) 234
Inhalation Solutions 235
Other 238
CHEMOTHERAPY DRUGS (J9000‑J9999) 239
TEMPORARY CODES ASSIGNED TO DME REGIONAL CARRIERS (K0000‑K9999) 243
Wheelchairs and Accessories 243
ORTHOTICS (L0100‑L4999) 249
Orthotic Devices: Spinal 249
Cervical 249
Multiple Post Collar 249
Thoracic 249
Thoracic‑Lumbar‑Sacral 249
Anterior‑Posterior‑Lateral Rotary‑Control 249
Sacroilliac, Lumbar, Sacral Orthosis 252
Cervical‑Thoracic‑Lumbar‑Sacral 255
Anterior‑Posterior‑Lateral Control 255
HALO Procedure 255
Additions to Spinal Orthoses 255
Orthotic Devices: Scoliosis Procedures (L1000‑L1520) 255
Scoliosis: Cervical‑Thoracic‑Lumbar‑Sacral (CTLSO) (Milwaukee) 255
Correction Pads 255
Scoliosis: Thoracic‑Lumbar‑Sacral (Low Profile) 256
Other Scoliosis Procedures 256
Orthotic Devices: Lower Limb 256
Hip: Flexible 256
Legg Perthes 257
Knee (KO) 257
Ankle‑Foot (AFO) 258
Hip‑Knee‑Ankle‑Foot (or Any Combination) 258
Torsion Control 259
Fracture Orthoses 259
Additions to Fracture Orthosis 259
Additions to Lower Extremity Orthosis 259
Shoe‑Ankle‑Shin‑Knee 259
Additions to Straight Knee or Offset Knee Joints 260
Gluteal/Ischial Weight Bearing 260
Additions to Pelvic and Thoracic Control 261
General Additions 261
Foot (Orthopedic Shoes) 261
Insert, Removable, Molded to Patient Model 261
Arch Support, Removable, Premolded 262
Arch Support, Non‑removable, Attached to Shoe 262
Abduction and Rotation Bars 262
Orthopedic Footwear 262
Shoe Modifications 263
Lifts 263
Wedges 263
Heels 264
Additions to Orthopedic Shoes 264
Transfer or Replacement 264
Orthotic Devices: Upper Limb 264
Shoulder 264
Elbow 265
Wrist‑Hand‑Finger Orthosis (WHFO) 265
Additions and Extensions 265
External Power 266
Other Wrist‑Hand‑Finger Orthoses: Custom Fitted 266
Shoulder‑Elbow‑Wrist‑Hand Orthosis (SEWHO) 267
Abduction Positioning: Custom Fitted 267
Additions to Mobile Arm Supports and SEWHO 267
Fracture Orthoses 267
Specific Repair 267
Repairs 268
Ancillary Orthotic Services 268
PROSTHETICS (L5000‑L9999) 268
Lower Limb (L5000‑L5999) 268
Partial Foot 268
Ankle 268
Below Knee 269
Knee Disarticulation 269
Above Knee 269
Hip Disarticulation 269
Hemipelvectomy 269
Endoskeleton: Below Knee 269
Endoskeletal: Above Knee 269
Endoskeletal: Hip Disarticulation 269
Endoskeletal: Hemipelvectomy 269
Immediate Postsurgical or Early Fitting Procedures 269
Initial Prosthesis 269
Preparatory Prosthesis 270
Additions to Lower Extremity 270
Additions to Test Sockets 270
Additions to Socket Variations 270
Additions to Socket Insert and Suspension 271
Additions/Replacements to Feet‑Ankle Units 272
Additions to Exoskeletal–Knee‑Shin System 272
Component Modification 272
Endoskeletal 273
Upper Limb 274
Partial Hand 274
Wrist Disarticulation 274
Below Elbow 274
Elbow Disarticulation 274
Above Elbow 275
Shoulder Disarticulation 275
Interscapular Thoracic 275
Immediate and Early Postsurgical Procedures 275
Endoskeletal: Below Elbow 275
Endoskeletal: Elbow Disarticulation 275
Endoskeletal: Above Elbow 275
Endoskeletal: Shoulder Disarticulation 275
Endoskeletal: Interscapular Thoracic 275
Additions to Upper Limb 276
Terminal Devices 277
Hooks 277
Hands 278
Replacement Sockets 278
Gloves for Above Hands 278
Hand Restoration 278
External Power 278
Base Devices 278
Terminal Devices 279
Elbow 279
Wrist 279
Battery Components 279
Other/Repair 279
General 280
Breast Prostheses 280
Nasal, Orbital, Auricular Prosthesis 280
Trusses 280
Prosthetic Socks 280
Prosthetic Implants 281
Larynx, Tracheoesophageal 281
Breast 281
Urinary System 281
Head (Skull, Facial Bones, and Temporomandibular Joint) 282
Upper Extremity 282
Lower Extremity (Joint: Knee, Ankle, Toe) 282
Miscellaneous Muscular‑Skeletal 282
Cardiovascular System 283
Neurostimulator 283
Unspecified 283
OTHER MEDICAL SERVICES (M0000‑M0301) 284
LABORATORY SERVICES (P0000‑P9999) 285
Chemistry and Toxicology Tests 285
Pathology Screening Tests 285
Microbiology Tests 285
Miscellaneous Pathology 285
TEMPORARY CODES ASSIGNED BY CMS (Q0000‑Q9999) 288
Cardiokymography 288
Chemotherapy 288
Smear, Papanicolaou 288
Equipment, X‑Ray, Portable 288
Laboratory 288
Drugs 288
Miscellaneous Devices 290
Fee, Pharmacy 291
Lens, Intraocular 291
Solutions and Drugs 291
Brachytherapy Radioelements 292
Telehealth 292
Drugs 292
Test, Skin 292
Supplies, Cast 292
Drugs 293
Skin Substitutes 293
Hospice Care 294
Miscellaneous 295
Contrast 295
DIAGNOSTIC RADIOLOGY SERVICES (R0000‑R9999) 297
Transportation/Setup of Portable Equipment 297
TEMPORARY NATIONAL CODES ESTABLISHED BY PRIVATE PAYERS (S0000‑S9999) 298
TEMPORARY NATIONAL CODES ESTABLISHED BY MEDICAID (T1000‑T9999) 313
Not Valid For Medicare 313
VISION SERVICES (V0000‑V2999) 316
Frames 316
Spectacle Lenses 316
Single Vision, Glass or Plastic 316
Bifocal, Glass or Plastic 316
Trifocal, Glass or Plastic 317
Variable Asphericity 317
Contact Lenses 317
Low Vision Aids 318
Prosthetic Eye 318
Intraocular Lenses 319
Miscellaneous 319
HEARING SERVICES (V5000‑V5999) 320
Speech‑Language Pathology Services 322