This page is part of the CARIN Blue Button Implementation Guide (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions 
XML Format: ValueSet-CARIN-BB-CPT-HCPCS-ProcedureCodes
Raw xml
<ValueSet xmlns="http://hl7.org/fhir"> <id value="CARIN-BB-CPT-HCPCS-ProcedureCodes"/> <meta> <versionId value="8"/> <lastUpdated value="2019-07-28T22:58:38.000+00:00"/> </meta> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><h2>CARIN Blue Button CPT/HCPCS Procedure Codes Value Set</h2><div><p>CPT is made managed by the American Medical Association (http://www.ama-assn.org/go/cpt)</p> <p>HCPCS Background Information Each year, in the United States, health care insurers process over 5 billion claims for payment. For Medicare and other health insurance programs to ensure that these claims are processed in an orderly and consistent manner, standardized coding systems are essential. The HCPCS Level II Code Set is one of the standard code sets used for this purpose. The HCPCS is divided into two principal subsystems, referred to as level I and level II of the HCPCS. Level I of the HCPCS is comprised of CPT (Current Procedural Terminology), a numeric coding system maintained by the American Medical Association (AMA). The CPT is a uniform coding system consisting of descriptive terms and identifying codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals. These health care professionals use the CPT to identify services and procedures for which they bill public or private health insurance programs. Decisions regarding the addition, deletion, or revision of CPT codes are made by the AMA. The CPT codes are republished and updated annually by the AMA. Level I of the HCPCS, the CPT codes, does not include codes needed to separately report medical items or services that are regularly billed by suppliers other than physicians.</p> <p>Level II of the HCPCS is a standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician's office. Because Medicare and other insurers cover a variety of services, supplies, and equipment that are not identified by CPT codes, the level II HCPCS codes were established for submitting claims for these items. The development and use of level II of the HCPCS began in the 1980's. Level II codes are also referred to as alpha-numeric codes because they consist of a single alphabetical letter followed by 4 numeric digits, while CPT codes are identified using 5 numeric digits.</p> </div><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in <code>http://www.ama-assn.org/go/cpt</code>, where the codes are contained in <a href="http://hl7.org/fhir/R4/valueset-cpt-all.html">http://hl7.org/fhir/ValueSet/cpt-all</a></li><li>Include all codes defined in <code>https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS.html</code></li></ul></div> </text> <url value="http://hl7.org/fhir/us/carin/ValueSet/carin-bb-cpt-hcpcs-procedurecodes"/> <version value="0.1.0"/> <name value="CARINBBCPTHCPCSProcedureCodes"/> <title value="CARIN Blue Button CPT/HCPCS Procedure Codes Value Set"/> <status value="draft"/> <date value="2019-12-23T19:40:59+00:00"/> <description value="CPT is made managed by the American Medical Association (http://www.ama-assn.org/go/cpt) HCPCS Background Information Each year, in the United States, health care insurers process over 5 billion claims for payment. For Medicare and other health insurance programs to ensure that these claims are processed in an orderly and consistent manner, standardized coding systems are essential. The HCPCS Level II Code Set is one of the standard code sets used for this purpose. The HCPCS is divided into two principal subsystems, referred to as level I and level II of the HCPCS. Level I of the HCPCS is comprised of CPT (Current Procedural Terminology), a numeric coding system maintained by the American Medical Association (AMA). The CPT is a uniform coding system consisting of descriptive terms and identifying codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals. These health care professionals use the CPT to identify services and procedures for which they bill public or private health insurance programs. Decisions regarding the addition, deletion, or revision of CPT codes are made by the AMA. The CPT codes are republished and updated annually by the AMA. Level I of the HCPCS, the CPT codes, does not include codes needed to separately report medical items or services that are regularly billed by suppliers other than physicians. Level II of the HCPCS is a standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician's office. Because Medicare and other insurers cover a variety of services, supplies, and equipment that are not identified by CPT codes, the level II HCPCS codes were established for submitting claims for these items. The development and use of level II of the HCPCS began in the 1980's. Level II codes are also referred to as alpha-numeric codes because they consist of a single alphabetical letter followed by 4 numeric digits, while CPT codes are identified using 5 numeric digits."/> <compose> <include> <system value="http://www.ama-assn.org/go/cpt"/> <valueSet value="http://hl7.org/fhir/ValueSet/cpt-all"/> </include> <include> <system value="https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS.html"/> </include> </compose> </ValueSet>
