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what is the difference between hcpcs and cpt codes

HCPCS and CPT codes are two different code sets for medical billing. Both can be used to submit claims. These code sets are maintained by two different entities. CPT codes are copyrighted and maintained by the American Medical Association. HCPCS codes are mainted by the Center for Medicare and Medicaid Services (CMS).

Which code set you used should be based upon choosing the code which most accurately describing the service that is performed. Whether that should be a CPT code or a HCPCS code should be determined by the provider.

Another factor to consider is where the claim will be submitted. It is always a good idea to check coverage from the insurance carrier / payer before submitting a claim. Tell them which procedure code and diagnosis code you intend to use.

There are many different code books, code software and internet code lookup tools available to help assist in choosing the correct code. www.instacode.com has both books available.

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