HCR 220 Week 6 - DQ 1 - 7698

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  • Posted on: Thu 12 Apr, 2012
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Request Description

 


Permanent national codes are maintained by the CMS HCPCS Workgroup. Decisions concerning additions, revisions, and deletions to the permanent national codes are the responsibility of the Workgroup. Private and public health insurers are the ones that use these codes. Because HCPCS is a national coding system, all payers will be represented in the Workgroup. Both private and public insurers manage the permanent national codes which provide a standardized coding system. This allows for a stable environment for claims submission and processing. On January 1 of each year, the national codes are updated.

Temporary national codes are for the purpose of meeting, within a short time period, the national program operational needs of a particular insurer that is not already addressed in the permanent code system. The CMS HCPCS Workgroup maintains these codes as well, and has set aside certain sections of the HCPCS code set to allow the Workgroup to develop temporary codes. The CMS uses these codes with discretion. This means that if the Workgroup needs a code in order to meet specific operating needs before the next scheduled annual update for permanent codes, it may establish a national temporary code. These temporary national codes are updated quarterly.

The result of a system without permanent codes would be a disaster. There would be no uniformity, no universal codes; everyone would have a different standard for their practice that was not familiar to others. Also, not all payers would be represented. The claims submission and processing would not be a stable environment which could delay the processing and create the possibility of denied payments.With such a disorderly processing and billing environment, the medical billing specialist would spend a lot of time and effort looking up the temporary codes that are added every quarter. This is time that could have been spent processing more claims. Without any of these codes being made permanent, there would be such a vast amount of codes to have to search through. This would make it virtually impossible to keep the staff updated. This could put the practice in jeopardy.

Solution Description

 


Permanent national codes are maintained by the CMS HCPCS Workgroup. Decisions concerning additions, revisions, and deletions to the permanent national codes are the responsibility of the Workgroup. Private and public h