Others titles
- Alpha Numeric HCPCS File
- Procedure Codes and Modifiers
- Alpha Numeric HCPCS File 2020
- Procedure Codes and Modifiers 2020
Keywords
- Billing Code
- HCPCS Book
- Common Procedure Coding System
- Claims Processing
- Alphanumeric HCPCS Procedure and Modifier Codes
- HCPCS Procedure Codes 2018
- HCPCS Modifier Codes 2018
- HCPCS Procedure Codes 2019
- HCPCS Modifier Codes 2019
- HCPCS Procedure Codes 2020
- HCPCS Modifier Codes 2020
Alpha-Numeric HCPCS Procedure and Modifier Codes
The Healthcare Common Procedure Coding System (HCPCS) dataset is a collection of codes that represent procedures, supplies, products and services which may be provided to Medicare beneficiaries and to individuals enrolled in private health insurance programs. These files contain the 2016, 2017, 2018, 2019 and 2020 alphanumeric HCPCS procedure and modifier codes and their long and short descriptions.
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Description
The 2016, 2017, 2018, 2019 and 2020 HCPCS (Healthcare Common Procedure Coding System) codes, which are established by CMS’s (Centers for Medicare & Medicaid Services) Alpha-Numeric Editorial Panel, primarily represent items and supplies and non-physician services not covered by the American Medical Association’s Current Procedural Terminology-4 (CPT-4) codes; Medicare, Medicaid, and private health insurers use HCPCS procedure and modifier codes for claims processing. 2019 alphanumeric procedure and modifier codes comprise the A to V range.” “With the exception of temporary codes, 2019 alphanumeric procedure and modifier codes are updated annually on January 1. Temporary codes, which begin with G, K, or Q, are updated on a flow basis throughout the year.
Level of the HCPCS is a standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician’s office. Because Medicare and other insurers cover a variety of services, supplies, and equipment that are not identified by CPT codes, the 2019 HCPCS codes were established for submitting claims for these items. The development and use of 2019 HCPCS began in the 1980’s. 2019 codes are also referred to as alpha-numeric codes because they consist of a single alphabetical letter followed by 4 numeric digits, while CPT codes are identified using 5 numeric digits.
About this Dataset
Data Info
Date Created | 2016-12-11 |
---|---|
Last Modified | 2022-09-05 |
Version | 2022-09-05 |
Update Frequency |
Annual |
Temporal Coverage |
2016-2020 |
Spatial Coverage |
United States |
Source | John Snow Labs; Centers for Medicare & Medicaid Services; |
Source License URL | |
Source License Requirements |
N/A |
Source Citation |
N/A |
Keywords | Billing Code, HCPCS Book, Common Procedure Coding System, Claims Processing, Alphanumeric HCPCS Procedure and Modifier Codes, HCPCS Procedure Codes 2018, HCPCS Modifier Codes 2018, HCPCS Procedure Codes 2019, HCPCS Modifier Codes 2019, HCPCS Procedure Codes 2020, HCPCS Modifier Codes 2020 |
Other Titles | Alpha Numeric HCPCS File, Procedure Codes and Modifiers, Alpha Numeric HCPCS File 2020, Procedure Codes and Modifiers 2020 |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
HCPCS_Code_ID | These are 2 to 5 position alphanumeric codes representing primarily items and nonphysician services that are not represented in the level I codes. | string | required : 1 |
Record_Identification_Code | Code to identify record type (3 = First line of procedure record also contains detail information in positions 92-275, 4 = Second, third, fourth, etc., Description of procedure record. No detail information in positions 92-275, 7 = First line of modifier record also contains detail information in positions 92-275, 8 = Second, third, fourth, etc., Description of modifier record. No detail information in positions 92-275) | integer | level : Nominal |
Long_Description | Long (full line / sentence) description of the code. | string | required : 1 |
Short_Description | Shortened, fixed-length description of the code. | string | - |
Pricing_Indicator_Code | Code used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes (00 = Service not separately priced by part B, 11 = Price established using national rvu's, 12 = Price established using national anesthesia, 13 = Price established by carriers, 21 = Price subject to national limitation amount, 22 = Price established by carriers, 31 = Frequently serviced DME, 32 = Inexpensive & routinely purchased DME 33 = Oxygen and oxygen equipment, 34 = DME supplies, 35 = Surgical dressings, 36 = Capped rental DME, 37 = Ostomy, tracheostomy and urological supplies, 38 = Orthotics, prosthetics, prosthetic devices & vision services, 39 = Parenteral and Enteral Nutrition, 45 = Customized DME items, 46 = Carrier priced, 51 = Drugs, 52 = Reasonable charge, 53 = Statute, 54 = Vaccinations, 55 = Splints and Casts, 56 = IOL's inserted in a physician's office, 57 = Other carrier priced, 99 = Value not established) | string | - |
Multiple_Pricing_Indicator_Code | Code used to identify instances where a procedure could be priced under multiple methodologies | string | - |
HCPCS_Code_Added_Date | The year the HCPCS (Healthcare Common Procedure Coding System) code was added to the Healthcare common procedure coding system. | date | - |
HCPCS_Action_Effective_Date | Effective date of action to a procedure or modifier code | date | - |
HCPCS_Termination_Date | Last date for which a procedure or modifier code may be used by Medicare providers. | date | - |
HCPCS_Action_Code | A code denoting the change made to a procedure or modifier code within the HCPCS system (A = Add procedure or modifier code, B = Change in both administrative data field and long description of procedure or modifier code, C = Change in long description of procedure or modifier code, D = Discontinue procedure or modifier code, F = Change in administrative data field of procedure or modifier code, N = No maintenance for this code, P = Payment change, R = Re-activate discontinued/deleted procedure or modifier code, S = Change in short description of procedure code, T = Miscellaneous change) | string | - |
Year | Year (2016,2017,2018) of Healthcare Common Procedure Coding System codes established by CMS | date | - |
Data Preview
HCPCS Code ID | Record Identification Code | Long Description | Short Description | Pricing Indicator Code | Multiple Pricing Indicator Code | HCPCS Code Added Date | HCPCS Action Effective Date | HCPCS Termination Date | HCPCS Action Code | Year |
A1 | 7 | Dressing for one wound | Dressing for one wound | 2002-07-01 | 2002-07-01 | N | 2016 | |||
A2 | 7 | Dressing for two wounds | Dressing for two wounds | 2002-07-01 | 2002-07-01 | N | 2016 | |||
A3 | 7 | Dressing for three wounds | Dressing for three wounds | 2002-07-01 | 2002-07-01 | N | 2016 | |||
A4 | 7 | Dressing for four wounds | Dressing for four wounds | 2002-07-01 | 2002-07-01 | N | 2016 | |||
A5 | 7 | Dressing for five wounds | Dressing for five wounds | 2002-07-01 | 2002-07-01 | N | 2016 | |||
A6 | 7 | Dressing for six wounds | Dressing for six wounds | 2002-07-01 | 2002-07-01 | N | 2016 | |||
A7 | 7 | Dressing for seven wounds | Dressing for seven wounds | 2002-07-01 | 2002-07-01 | N | 2016 | |||
A8 | 7 | Dressing for eight wounds | Dressing for eight wounds | 2002-07-01 | 2002-07-01 | N | 2016 | |||
A9 | 7 | Dressing for nine or more wounds | Dressing for 9 or more wound | 2002-07-01 | 2002-07-01 | N | 2016 | |||
AA | 7 | Anesthesia services performed personally by anesthesiologist | Anesthesia perf by anesgst | 1984-01-01 | 2001-01-01 | N | 2016 |