Accurately report supplies and services for physician, hospital outpatient, and ASC settings with the HCPCS Level II Professional 2025. Use this comprehensive reference for the HCPCS Level II code set that focuses on management of reimbursement. This user-friendly book guides any coder confidently through current modifiers, code changes, additions, and deletions with information as dictated by the Centers for Medicare and Medicaid Services (CMS).
Brand new features added to this HCPCS code book:
- New – Expanded Modifier appendix. Includes HCPCS Level II modifiers and descriptions and easy-to-understand guidance and coding tips for some of the more difficult modifiers, assisting in appropriate usage and reimbursement.
- New – Helpful illustrations. Detailed color anatomy illustration chapter. Plus, many illustrations at the code level identifying specific code-related supplies and services.
Professional and all Optum HCPCS Level II editions include these hallmark features:
- Comprehensive code updates.
- Table of Drugs. Locate both generic and brand-name drugs and their corresponding codes based on the amount and route of administration.
- Code level documentation tips. When appropriate, guidance is provided to assist correct coding.
- APC status indicators and ASC designation symbols. Determine which codes are payable under OPPS and which codes enable billing using ASC groupings, as well as how to accurately use each to help ensure appropriate billing and reimbursement.
- Comprehensive Drug Information. The C and J code sections include a listing of a common drug(s) to be used for that code. Also, as needed, a coding tip and/or drug notation is provided.
- DMEPOS icon. Distinguish codes paid under the DMEPOS fee schedule to improve efficiency when coding for supplies that should be submitted under the system to durable medical payers.
- In-depth illustrations. Enhance your coding process and accuracy for supplies and services with detailed visual references.
- AHA Coding Clinic for HCPCS references. Receive additional support with articles on
difficult-to-code HCPCS Level II codes or sections. - Color-coded bars and icons. Spot important information to help reduce inaccurate and denied claims with informative flags signaling Internet Only Manuals (IOM, formerly Pub. 100) references, age and gender edits, quantity alerts, new/deleted/revised code changes, and government coverage and rules for each code.
- User-friendly appendixes. Navigate additional information easily with structured references and excerpts, including a comprehensive drug table, acronyms/abbreviations, and modifiers.
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