HCPCS vs. CPT both are codes used in the medical field. Most people confuse these people with one another. But these are two totally different codes. The main difference between HCPCS and CPT is that HCPCS is a set code used by medical workers to claim their health insurance from insurance companies. CPT is a code, especially for the usage of medical students by the authorities.
Let’s take a closer look at CPT vs. HCPCS
|Developed In||HCPCS was developed in 1996, while CPT was in 1978|
|Creators||HCPCS was created by CMS, while CPT was by AMA|
|Access||HCPCS has free access, while CPT has a paid access|
|Divided||HCPCS was divided into three levels, while CPT was into three categories|
What Is HCPCS?
If we look at HCPCS meaning, it is a Healthcare Common Procedural Coding System. These codes are specially developed by the Centre for Medicare and Medicaid organizations. These codes are used by healthcare workers to claim their medical insurance from insurance companies. Now HIPAA makes it possible for everyone to use these codes. It is free of cost and has three levels, Level-I, Level-II, and Level III. Level-I consists of the CPT codes addressed by the American Medical Association. These CPT codes are mainly used by healthcare workers to offer certain services to patients. Level II consists of the codes which are related to the non-physical service providers. For example, the ambulance service. The last Level III is known as local codes. Which looks up the medical history of the patients and provides the description for healthcare insurance of some programs.
What Is CPT?
If we look at the CPT meaning, it is Current Procedural Terminology. These codes are developed by the American Medical Association. These codes provide direction for the medical professional to consider while attending to the patient. These codes are also published in the CPT editorial panel in the American Medical Association. These codes are divided into categories: Category 1, Category 2, and Category 3. Category 1 consists of six sections, which are influenced by medical workers and head ones. These sections are basically odes for medicine, surgery, pathology, radiology, anesthesia, evaluation and management. Category 2 provides the description of the codes which have to be followed by the ones who are evaluating and managing the patients. The last, Category 3, is developed to address emerging technology in the medical field. But this category is paid for by every organization, which is the desire to access this s. It is owned by the AMA.
6 Key Differences Between HCPCS and CPT
|Definition||It is a Healthcare Common Procedural Coding System specially developed by the Centre for Medicare and Medicaid organizations.||It is Current Procedural Terminology. Which are developed by the American Medical Association to provide direction to the medical professional.|
|Significance||These codes provide a standardized des description for delivering healthcare services.||These codes provide a standardized description, which has to be acknowledged by the medical workers.|
|Ownership||These codes were developed under the Healthcare and Information Probability and Protection Act of 19976, so these are free.||These codes are registered trademarks of the American Medical Association, so one who wants access has to pay for the procedure.|
|Protection||Everyone can get free access to the HCPCS procedures.||Outsiders have to pay for getting the services of CPT procedures.|
|Divisions||These codes are divided into Level-I, Level II, and Level III.||These are divided into three categories, Category 1, Category 2, and Category 3.|
|Affect||These codes affect both direct healthcare workers and non-direct healthcare workers.||These codes only provide procedures for the operation of patients.|
HCPCS vs. CPT Similarities
- Whether it is HCPCS or CPT, both are specific codes for people related to the medical field.
- Both codes are are further divided into three subdivisions
HCPCS vs. CPT Examples
- Medical and surgical supplies
- Eternal and parenteral therapy
- Office Visit
- Administration of flu shot
- Performance measurement
HCPCS vs. CPT Pros and Cons
HCPCS Pros and Cons
Pros of HCPCS
- HCPCS are very important codes used for the purpose of billing and to represent medical procedures, services and supplies.
- These codes are also used for facilitating the process of health insurance claims by medicare and other insurers.
Cons of HCPCS
- Getting HCPCS registration can be difficult for overseas physiotherapists and can be problematic, as it requires some documentation.
- The coding determination often required the review of clinical evidence similar to the information of coverage policies, which can take some time to provide.
CPT Pros and Cons
Pros of CPT
- CPT offers doctors and other healthcare professionals a league for coding medical services and a procedure to increase accuracy and efficiency.
- CPT modifiers are very helpful in describing the importance of the procedure and the location of the body where the procedure is performed.
Cons of CPT
- A disadvantage of performing the CPT is that outsiders have to pay in order to get access to this facility. This cost also includes export fee and taxes.
- Sometimes coding errors can occur while registrations which can lead to serious problems like fraud and abuse lines.
HCPCS and CPT are both specific codes for people related to the medical field. But if we talk about HCPCS vs. CPT differences, HCPCS Is a Healthcare Common Procedural Coding System. These codes are specially developed by the Centre for Medicare and Medicaid organizations. While CPT is, it is Current Procedural Terminology. These codes are developed by the American Medical Association. And has three levels, Level-I, Level II, and Level III. CPT has three categories: Category 1, Category 2, and Category 3. If we compare HCPCS Versus CPT cost, the HCPCS procedure is free for everyone, while the outsiders have to pay the cost if they have a desire for CPT procedures.