Question

Medical Coding Using HCPCS Case Scenario

You are a new medical coder that works for a small OB/GYN practice. A common procedure performed daily for many patients is that of a routine pap smear.

Apply your knowledge of HCPCS to the procedure above.

Include the following aspects in the assignment:

Ø  Describe what HCPCS is and how this code set is used

Ø  Provide two examples of when these codes would be used in an outpatient setting

Ø  Provide two examples of when these codes would be used in an inpatient setting

Ø  Place the HCPCS code for a routine pap smear

Ø  List the steps of how you arrived at this code is important for reimbursement purposes

Answer 1

Healthcare common procedural coding system(HCPCS) is a standardized coding system necessary for medical providers to submit healthcare claims to Medicare,Medicaid and other third-party payers in a consistent and orderly manner.it is developed by Centre for Medicare and Medicaid services (CMS).HCPCS code contain two set codes published in two manuals,one is CPT and HCPCS level II.Level II of HCPCS is a standardized coding system that is primarily used to identify products,supplies and services not listed in CPT4 codes such as ambulance services, durable medical equipment, prosthetics, orthotics and supplies when used outside a physician's office.

Routine laboratory services in a physician's office requires HCPCS coding.Also transportation services including ambulance comes under HCPCS coding.

Orthopedic doctors often treat patients with spillers,braces,wraps and other orthotic devices.Also alcohol and drug abuse treatment in a inpatient setting uses HCPCS codes.

HCPCS code for a routine pap smear is Q0091.Q codes are used for drugs, supplies and biologicals which have not been assigned permanent codes.Q0091 is screening pap smear, obtaining,preparing and conveyance of cervical or vaginal smear to laboratory.