HCPCS Level II Codes Flashcards

HCPCS Level II codes are updated and maintained by which organization?

Answer: CMS (Centers for Medicare & Medicaid Services)

CMS is responsible for maintaining and updating HCPCS Level II codes, which are updated annually and as needed throughout the year.

A patient with diabetes receives insulin syringes from a DME supplier. Which HCPCS code category applies?

Answer: A codes

Insulin syringes and related diabetic supplies are reported using A codes (specifically A4206 and related supply codes).

Which HCPCS Level II code series covers enteral and parenteral nutrition supplies?

Answer: B codes

B codes (B4000–B9999) are specifically designated for enteral and parenteral nutrition therapy, including pumps, supplies, and nutrients.

A bilateral below-knee prosthesis is being reported. Which HCPCS Level II modifier should be appended to indicate bilateral procedure?

Answer: -RT and -LT

For HCPCS Level II bilateral DME/prosthetics, the -RT (right side) and -LT (left side) modifiers are used on separate line items rather than the CPT bilateral modifier -50.

Which of the following is true regarding HCPCS Level II V codes?

Answer: They are used for vision and hearing services and supplies

V codes (V0000–V5364) cover vision and hearing services, including eyeglasses, contact lenses, and hearing aids.

When a Medicare patient requires a capped rental item that converts to a purchase, which modifier signals the month of the rental?

Answer: -KH, -KI, -KJ

The KH, KI, and KJ modifiers indicate the 1st, 2nd–3rd, and 4th–15th months of a capped rental, respectively, used for DME billing under Medicare.

A physician administers Botulinum toxin type A (Botox) for spasticity in an office setting. Which HCPCS Level II category is used?

Answer: J codes

Botulinum toxin type A is reported with J0585 (per unit), which falls under J codes used for injectable drugs administered by a physician.