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What does HCPCS mean?

HCPCS codes and what they mean in medical billing

HCPCS stands for: Healthcare Common Procedure Coding System


HCPCS codes are a coding set that identifies equipment, supplies, and products that are not included in CPT (procedure) codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician's office. 

HCPCS codes are maintained by the American Medical Association (AMA) and are updated yearly. 

The main reason HCPCS codes are important to medical billing in dentistry is the custom made oral appliance used to treat Obstructive Sleep Apnea (OSA). The code used to represent these appliances is a durable medical equipment (DME) HCPCS codes: E0486 - Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment.

HCPCS codes are entered into field 24D of the CMS1500 medical claim form (in the same field that you would enter a CPT code):

Below are a few examples of other HCPCS codes that may be used in medical billing in dentistry, although they are not commonly used:

E0485 - Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment

A9270 - Non-covered item or service

E1399 - Durable medical equipment, miscellaneous

A9900 - Miscellaneous DME supply, accessory, and/or service component of another hcpcs code

A9999 - Miscellaneous DME Supply or Accessory, Not Otherwise Specified