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HCPCS modifiers

The Health Care Common Procedure Coding System (HCPCS) is used to help code services for Medicare patients. Just like many other coding systems, they use modifiers. However, the modifiers are not the same ones used by CPT codes even though some HCPCS codes are the same as the CPT level one codes. While you are going through your work for the day, you notice that you need to use the HCPCS modifiers to complete your coding for the day's claims. After a thorough search, the only modifiers that you can find are the CPT modifiers. Why can't you use these modifiers, and what problems can it cause if you use them instead of the modifiers specifically formatted for the HCPCS codes?

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The Healthcare Common procedure Coding System (HCPCS) is a standardized coding system intended to provide a uniform, fairly universal form of descriptive terms and identifying codes. This are used primarily to identify medical services and procedures furnished by physicians and other health care professionals.

Billing computers receiving claims are programmed to accept the standardized codes and accepted modifiers for each code. They usually automatically reject any deviation of the coding, resulting in time wasted and longer recuperation of costs.
If the HCPCS used didn't have a modifier assigned in the ...

Solution Summary

The solution includes a discussion of the importance of using the correct CPT and HCPCS modifiers for the medical bill to get paid on time.