Category Archives: Medical Practice Information

List of HCPCS Categories

The letters at the beginning of HCPCS Level II codes have the following meanings:

  • A-codes (example: A0021): Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental
  • B-codes (example: B4034): Enteral and Parenteral Therapy
  • C-codes (example: C1300): Temporary Hospital Outpatient Prospective Payment System
  • D-codes: Dental Procedures
  • E-codes (example: E0100): Durable Medical Equipment
  • G-codes (example: G0008): Temporary Procedures & Professional Services
  • H-codes (example: H0001): Rehabilitative Services
  • J-codes (example: J0120): Drugs Administered Other Than Oral Method, Chemotherapy Drugs
  • K-codes (example: K0001): Temporary Codes for Durable Medical Equipment Regional Carriers
  • L-codes (example: L0112): Orthotic/Prosthetic Procedures
  • M-codes (example: M0064): Medical Services
  • P-codes (example: P2028): Pathology and Laboratory
  • Q-codes (example: Q0035): Temporary Codes
  • R-codes (example: R0070): Diagnostic Radiology Services
  • S-codes (example: S0012): Private Payer Codes
  • T-codes (example: T1000): State Medicaid Agency Codes
  • V-codes (example: V2020): Vision/Hearing Services

Billing Q&A: What are HCPCS?

HCPCS stands for Healthcare Common Procedure Coding System (HCPCS). For Medicare and other health insurance programs to ensure health care claims are processed in an orderly and consistent manner, standardized coding systems are essential. The HCPCS Level II code set is one of the standard code sets used by medical coders and billers for thisContinue Reading

Medical & Business Industry Leaders to follow

We get asked frequently on who is a good resource for a Medical Practice.  We have comprised a list [specific in some areas to the State of Texas as that is where our business originates from].  Below is a list that will help you get started if you are working or interested in the MedicalContinue Reading

Billing Q&A: Covering for a Colleague

In part of our Question & Answer Series, today we address a common question about how to do billing when you are covering for another physician. Q:  If I am covering for another physician and see some of his/her patients during his/her absence, are these patients considered new or established? A:  The CPT guidelines specifically addressContinue Reading

How do you get physicians to buy into ICD-10?

Each phase is the prerequisite for the next. Acquiring physician “buy‐in” must be accomplished in order to proceed to the planning and implementation phases. Because many physicians don’t know what they need to know about ICD‐10 in order to implement, analyze, and make informed choices, most practices are currently in Phase One: Engaging and educatingContinue Reading

The ICD-10-CM Foundation and Background

Definition of Terms In order to be able to discuss the transition from ICD‐9‐CM to ICD10‐CM, you first need to understand the “language” in which the new coding process communicates. Following are terms you need to know. Important Terms for ICD-10 Covered Entity: Providers, payers and clearinghouses who conduct specific administrative transactions electronically. EDI: ElectronicContinue Reading

Verifying Texas Medicaid Eligibility

Each person approved for Medicaid benefits gets a Your Texas Benefits Medicaid card. However, having a card does not necessarily mean the patient has current Medicaid coverage. You must still verify eligibility. There are several ways to do this: • Swipe the patient’s Your Texas Benefits Medicaid card through a standard magnetic card reader, ifContinue Reading

EHR Incentive Payment Audits

EHR Incentive Payment Audits The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 authorized the implementation of the Texas Medicaid Electronic Health Record (EHR) Incentive Program. The Medicaid/CHIP Division of the Texas Health and Human Services Commission (HHSC) began making incentive payments to eligible providers and eligible hospitals in 2011 forContinue Reading

Steps to Avoid EHR Incentive Payment Delays

Eligible professionals who want payments assigned directly to them must have Social Security number on file with TMHP Eligible professionals (EPs should be aware of the following before beginning enrollment in the Texas Medicaid Electronic Health Record (EHR) Incentive Program: If you will be assigning the incentive payment to yourself, your Social Security number (SSN)Continue Reading

EHR Incentive Payment Overview

Under the provisions of the HITECH Act, State Medicaid programs are establishing EHR Incentive Programs. These programs provide for incentive payments to certain health care professionals and hospitals that meet specific eligibility requirements when they adopt, implement, and meaningfully use certified EHR technology. To be eligible for incentive programs, health care professionals and hospitals mustContinue Reading