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HCPCS Level II Coding Flashcards

7 cards from real CMC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 HCPCS Level II Coding flashcards as text

  1. A Medicare patient receives a power wheelchair. Which HCPCS Level II code range is most appropriate?

    Answer: E codes (DME)

    Power wheelchairs are classified as Durable Medical Equipment (DME) and are found in the E code range (E1130–E1298) of HCPCS Level II.

  2. HCPCS Level II S codes are primarily used by which payers?

    Answer: Private insurers and Medicaid (non-Medicare payers)

    S codes are used by private insurers and Medicaid for items and services not covered by Medicare or not yet accepted for Medicare billing purposes.

  3. When billing Medicare for a non-covered item, which approach is correct?

    Answer: Append the appropriate modifier such as GY or GA to the HCPCS code

    When billing non-covered items to Medicare, modifiers such as GY (statutorily excluded) or GA (ABN on file) are appended to communicate the coverage status to the payer.

  4. Which of the following best describes a HCPCS Level II 'miscellaneous' or 'not otherwise classified' code?

    Answer: A code used when no specific code adequately describes the item or service

    Miscellaneous HCPCS codes (e.g., E1399, A9999) are used when no other specific code adequately describes the item or service being billed and typically require additional documentation.

  5. What is the primary purpose of HCPCS Level II T codes?

    Answer: State Medicaid agency codes for items and services not covered by national Medicare/Medicaid codes

    T codes are used by state Medicaid agencies for items and services not covered by the Medicare or national Medicaid system but required by individual state Medicaid programs.

  6. A supplier provides a custom-fabricated below-knee prosthetic limb to a patient. Which HCPCS Level II code section applies?

    Answer: L codes

    L codes (L5000–L9999) cover prosthetic devices including custom-fabricated prosthetic limbs for lower and upper extremities.

  7. Which of the following is TRUE regarding the HCPCS Level II annual update cycle?

    Answer: Codes are updated annually by CMS, typically taking effect January 1st

    HCPCS Level II codes are updated annually by CMS, with new codes, revisions, and deletions typically taking effect on January 1st of each calendar year.