The charge on the unpaid claim is for a consultation using code 99242. What type of HCPCS code is this?
Level 1
Level 2
Level 3
Level 4
Level 5
Level 5
The HCPCS code 99242 is a Level 4 code.
To determine the type of HCPCS code for the consultation using code 99242, you need to understand the HCPCS coding system.
HCPCS stands for Healthcare Common Procedure Coding System, which is a standardized coding system used for the identification and billing of medical procedures and services. It is divided into two levels: Level 1 and Level 2.
Level 1 of the HCPCS coding system is the Current Procedural Terminology (CPT) codes. These codes are maintained and copyrighted by the American Medical Association (AMA). CPT codes are used to describe medical procedures, services, and evaluations provided by healthcare professionals.
Level 2 of the HCPCS coding system is the alphanumeric codes called HCPCS Level II codes. These codes are used for products, supplies, and services not covered by CPT codes. HCPCS Level II codes are maintained and regulated by the Centers for Medicare and Medicaid Services (CMS).
Code 99242 is a CPT code, which means it belongs to Level 1 of the HCPCS coding system. CPT code 99242 specifically refers to an outpatient consultation for a new or established patient requiring a moderate level of medical decision making. This code is commonly used for consultations performed by physicians or other qualified healthcare professionals.
So, the correct answer to your question is Level 1.