Difference Between HCPCS and Procedure Codes (With Table)

HCPCS and the Procedure Codes are considered to be working side by side in what they do. The HCPCS generally assures the protection of their medical services to the various insurance agencies for safety reasons. On the contrary, the Procedure Codes are used to keep records of the processes or medication services done to the specific patient. 

HCPCS vs Procedure Codes

The difference between the HCPCS and Procedure code is that HCPCS is made in a way to provide the coding system to maintain the various medical care and emergency services with the use of the codes. While the procedure codes are the codes that are essentially used to track the medicines or services that are provided to any patient and to follow them properly.

The HCPCS are one containing several codes to maintain medical proficiency which comprises of three levels that are Level 1, Level 2, and Level 3 respectively. HCPCS requires the use of codes to ensure administration. The next Level 2 coding is used for the services of medical laborers to guarantee the medical protection of the instruments. 

The procedure codes are the codes used in medical facilities with the HCPCS level 1 code. The procedure codes carry the medical systems that the clinical practitioners need to follow during any medical service. There are three categories of the coding system of Procedure Codes are Category 1, Category 2, and Category 3 for the various requirements of medical urgency.

Comparison Table Between HCPCS and Procedure Codes 

Parameters of Comparison               HCPCS      Procedure Codes
Developer HCPCS are codes developed by the (CMS).The procedure codes are developed by the (AMA).
Utilized in the field ofHCPCS codes provide healthcare services to patients.Procedure codes provide the services that the medical workers should be provided with.
Divisions of codesHCPCS codes have Level 1, Level 2, and Level 3.Procedure codes possess Category 1, Category 2, and Category 3.
Accessibility The HCPCS are available for everyone.Procedure codes are paid facilities for outsiders.
ServicesFor both direct and non-direct healthcare workers.Only made with the purpose of procedures operated upon a patient.

What is HCPCS?

HCPCS codes are codes created for medical strategies. It is meant to recognize the protection process which one is qualified for. Due to the rules passed by HIPAA, the HCPCS has been made available by anyone to access. HCPCS has three levels, and each one of these levels is meant to show the required methods. 

Level 1 of HCPCS contains the codes that are also the procedures codes being made use of by the health workers for the services they provide to the patient. The medical comprises of the strategies with the use of codes that must be known while working services on a patient. 

Level 2 of HCPCS has the codes that are used for emergency vehicle administration purposes with non-actual specialist co-ops and the Level 2 codes of HCPCS are arranged by a capital letter followed by a specific four-digit number for identification. As, code A0021 implies the methods noted for Medical services, supplies of surgeries or transportation purposes, or various other services.

The Level 3 codes of HCPCS are known as the neighborhood codes and are not being used extensively but were acquired of experience till Dec 31, 2003. After few years, a more well-founded form of codes was prepared by the medical organization to show the health insurance of a specific medical program. 

What are Procedure Codes?

The procedure codes are known to adhere to the methodology that a health worker must strictly follow while a health worker is looking for a patient. The coding system of procedure codes is distributed by the board in the AMA. The procedure codes comprise three categories.

Category 1 of procedure codes contains six main segments where the codes are used to assess the medical procedures and various research centers and also use of codes for medication purpose. The clinical specialists are in need of these codes to carry on with the procedures and medical services.

The 2nd category in procedure codes follows the codes that progress the need to follow while assessing and tending a patient. The leading body of procedure codes – Performance Measures Advisory Group makes the required changes and checks this classification. Even these codes start with four digits followed by a capital letter for identification.

The 3rd category of procedure code focuses on innovation in the medical field. Any third party or outsider association that shows the requirements of getting these procedure codes needs to pay them for doing so.

Main Differences Between HCPCS and Procedure codes

  1. HCPCS is considered as the general depiction of the methods and processes which a health expert needs to adhere to while attending to a patient. Whereas, the Procedure codes comprise the codes that show the arrangement of techniques needed to be followed.
  2. For the HCPCS codes, HIPAA made it mandatory for anyone to get free access to these codes. While the procedure codes are protected by the AMA and thus are mandatory to be paid before taking the assistance.
  3. The HCPCS comprises three levels of the coding system that are Level 1, Level 2, and Level 3. On the other hand, the procedure codes are of three categories that are Category 1, Category 2, and Category 3.
  4. The Centers for Medicare and Medicaid are the authorization of the HCPCS. On the contrary, the AMA is the authorization of the procedure codes.
  5. The HCPCS codes can be made use by both direct and indirect medical health workers. Whereas, the procedure codes are sort of a guideline to be followed while attending to a patient.

Conclusion

Both the HCPCS codes and procedure codes are used in the administrative services of a health department that are offered by the medical health workers. The HCPCS has various levels of codes and each one of these levels has the specific codes that various individuals or medical workers assigned in the medical field need to strictly maintain while taking care of a patient during health facilities. While they are practicing their clinical protection, these are needed to be followed. 

The procedure codes are the codes that have an integral contribution to the coding system of the HCPCS and they carry the codes which are mandatory for the health experts to follow while diagnosing and treating a particular patient. The procedure codes have three categories of coding systems to progress their job of operating codes. 

Like analysis codes, there might be numerous strategy codes on a clinic guarantee. Every clinical case that is shipped off an insurance agency should have in any event one technique code on it, in any case, the case will be denied. The method code doesn’t need to be a technique, however. It very well may be what’s known as an assessment, E&M, or visit code, which means the time, spot of administration, or kind of persistent a doctor has seen a patient. It can likewise be a lab test, which is viewed as a technique even though occasionally the patient might not have been at the office that took the sample.

References

  1. https://www.liebertpub.com/doi/abs/10.1089/wound.2013.0483
  2. https://www.sciencedirect.com/science/article/pii/S0895435606000230
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