Tip: HCPCS and CPT codes in Part B

Dec 06, 2019
The Bottom Line

The HCPCS and CPT codes are updated annually. SNFs must stay on top of the annual updates as well as CMS program memorandums listing changes to HCPCS codes for consolidated billing purposes. For rehabilitation, the therapist should use the AMA’s CPT coding definitions. For other services and supplies, double-check the accuracy of codes for services and items provided by the vendor.

It is important that the Medicare biller confirm the coding with a certified coder or another professional with the proper coding training. Some procedures will have both a HCPCS code and a CPT code. The coding specialist will determine which should be used for which types of claims. For example, colonoscopies are properly coded with CPT 45378 for non-Medicare claims and either the HCPCS code G0105 or G0121 on Medicare claims.

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