Billing: Coding

HCPCS and CPT coding

  • The HCFA (Health Care Financing Administration) Common Procedural Coding System (HCPCS) and the CPT (Current Procedural Terminology) codes are used to describe specific tests or services.
    • The amount of payment for a test is dependent on the HCPCS or CPT code.
    • HCPCS or CPT codes should be assigned under the supervision of the laboratory technical staff.
    • Billing department employees should never change a HCPCS or CPT code without the approval of a manager or compliance officer.
    • If a billing department clerk notices that a particular HCPCS or CPT code is being rejected by a payer they should report it to their manager.
    • It is against the law to use the wrong HCPCS or CPT code for the purpose of causing or increasing payment for a test.

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