The charge on the unpaid claim is for a consultation using code 99242. What type of HCPCS code is this?
The HCPCS code 99242 is a Current Procedural Terminology (CPT) code, not an HCPCS code. It is used to report an office or outpatient consultation for a new or established patient.
The HCPCS code 99242 is a level 2 Current Procedural Terminology (CPT) code. CPT codes are used to report medical procedures and services performed by healthcare professionals in the United States. The level 2 codes are specific to non-physician services, such as consultations and durable medical equipment.
To determine the type of HCPCS (Healthcare Common Procedure Coding System) code for the consultation using code 99242, you can follow these steps:
1. Visit the Centers for Medicare and Medicaid Services (CMS) website, as they maintain and update the HCPCS coding system.
2. Navigate to the HCPCS Code Sets page on the CMS website. You can find it by searching "HCPCS Code Sets CMS" in a search engine.
3. Once you're on the HCPCS Code Sets page, you will see a list of different code sets. Look for the section titled "Alpha-Numeric HCPCS."
4. Click on the link provided for the current year's alpha-numeric HCPCS file. For example, if the current year is 2021, click on the link that says "2021 Alpha-Numeric HCPCS File."
5. This will download a file containing all the HCPCS codes and their descriptions for the specified year.
6. Open the downloaded file, and use the search function (usually Ctrl+F) to search for the specific code 99242.
7. Locate the entry for code 99242, and look at the corresponding code type.
8. The code type will specify whether the code is categorized as a Level I HCPCS code (CPT code) or a Level II HCPCS code (National codes).
Following these steps will enable you to determine the type of HCPCS code for the consultation using code 99242.