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VA Technical Reference Model v 21.7

Healthcare Common Procedure Coding System (HCPCS)
Healthcare Common Procedure Coding System (HCPCS) Standard or Specification

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Description: The Healthcare Common Procedure Coding System (HCPCS) is a set of health care procedure codes based on the American Medical Association`s Current Procedural Terminology (CPT). Commonly pronounced Hick-Picks.HCPCS includes three levels of codes: - Level I consists of the American Medical Association`s Current Procedural Terminology (CPT) and is numeric. - Level II codes are alphanumeric and primarily include non-physician services, such as ambulance services and prosthetic devices, and represent items and supplies and non-physician services not covered by CPT-4 codes (Level I). Level II alphanumeric procedure and modifier codes are a single alphabetical letter followed by 4 numeric digits; the first alphabetic letter is in the A to V range. Level II codes are maintained by the US Centers for Medicare and Medicaid Services (CMS). There is some overlap between HCPCS codes and National Drug Code (NDC) codes, with a subset of NDC codes also in HCPCS, and vice-versa. The CMS maintains a crosswalk from NDC to HCPCS in the form of an Excel file. The crosswalk is updated quarterly. - Level III codes, also called local codes, were developed by state Medicaid agencies, Medicare contractors, and private insurers for use in specific programs and jurisdictions. The use of Level III codes was discontinued on December 31, 2003, in order to adhere to consistent coding standards.
Technology/Standard Usage Requirements: Users must ensure their use of this technology/standard is consistent with VA policies and standards, including, but not limited to, VA Handbooks 6102 and 6500; VA Directives 6004, 6513, and 6517; and National Institute of Standards and Technology (NIST) standards, including Federal Information Processing Standards (FIPS). Users must ensure sensitive data is properly protected in compliance with all VA regulations. Prior to use of this technology, users should check with their supervisor, Information Security Officer (ISO), Facility Chief Information Officer (CIO), or local Office of Information and Technology (OI&T) representative to ensure that all actions are consistent with current VA policies and procedures prior to implementation.
Section 508 Information:
Decision: View Decisions

Decision Source: TRM Mgmt Group
Decision Process: One-VA TRM v19.4
Decision Date: 04/16/2019
Aliases: Hick-Picks, HCPCS
Introduced By: TRMSP
Standards Body: CMS
- The information contained on this page is accurate as of the Decision Date (04/16/2019).