Certified Medical Assistant (CMA AAMA)Administrative: Billing, Coding and SchedulingMedium
A durable medical equipment supplier bills for a patient's wheelchair. Which coding system is used to report this item on the claim?
- AICD-10-PCS
- BCPT Category I
- CHCPCS Level II
- DICD-10-CM
Show answer & explanationAnswer & explanation
Correct answer: C. HCPCS Level II
HCPCS Level II codes are alphanumeric codes (letter followed by four digits) used to report supplies, durable medical equipment, ambulance services, and drugs not covered by CPT codes. ICD-10-CM codes report diagnoses, CPT Category I codes report procedures/services, and ICD-10-PCS is used for inpatient hospital procedure coding.
Why the other options are wrong
- A. ICD-10-PCS is used exclusively for inpatient hospital procedure coding, not outpatient equipment billing.
- B. CPT Category I codes represent physician procedures and services, not durable medical equipment.
- D. ICD-10-CM codes represent diagnoses, not equipment or supplies.
HCPCS Level II
A standardized coding system used to report supplies, durable medical equipment (DME), ambulance services, and certain drugs/biologicals not included in CPT codes.
- Alphanumeric format: one letter followed by four numbers (e.g., E-codes for DME)
- Used for Medicare/Medicaid billing of supplies and equipment
- Different from CPT (procedures) and ICD-10-CM (diagnoses)
Memory trick: HCPCS Level II = 'Hardware, Crutches, Prosthetics, Chairs, Supplies'