Medicare Claim Codes Overview
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Questions and Answers

Match the following code types with their primary usage:

C codes = Valid only on Medicare claims for hospital outpatient prospective payment system G codes = For professional component of services not found in CPT H codes = Identify mental health services for state Medicaid agencies K codes = Used when no permanent national codes exist for the product

Match the following codes with their descriptions:

S codes = For private insurers to identify drugs and services T codes = For state Medicaid agencies when there are no permanent national codes L codes = For drugs and medical equipment not identifiable in Level II codes C codes = Specific to hospital outpatient prospective payment system claims

Match the code types to the corresponding healthcare components:

G codes = Professional services not listed in CPT H codes = Alcohol and drug treatment services S codes = Medicaid services not reimbursable under Medicare L codes = Medical equipment billing claims

Match the following code types with the insurer requirements:

<p>K codes = Used when no permanent national codes exist C codes = Only valid on Medicare claims T codes = Can be used for private insurers but not Medicare S codes = Identified for drugs covered by private insurers</p> Signup and view all the answers

Match the following code types with their specific usages:

<p>L codes = For services requiring no CPT codes C codes = Hospital outpatient prospective payment system G codes = Services in professional medicine not listed in CPT H codes = Mental health service identification for Medicaid</p> Signup and view all the answers

Study Notes

Codes Used for Medicare Claims

  • C codes: Valid only for Medicare claims and used specifically for the hospital outpatient prospective payment system.

Codes Used for Professional Services and Procedures

  • G codes: Used for professional services and procedures not found in the CPT.

Codes Used for Drugs, Medical Equipment, and Services

  • L codes: Used for drugs, medical equipment, and services that do not have CPT codes and are not identifiable in Level II codes but are needed to process a billing claim.

Codes Used When No Permanent National Codes Exist

  • K codes: Used when no permanent national codes exist for the product or supply.

Codes Used for Private Insurers

  • S codes: Used by private insurers to identify drugs, services, supplies, and procedures. They are also used by Medicaid program but are not reimbursable under Medicare.

Codes Used for State Medicaid Agencies

  • H codes: Used by state Medicaid agencies to identify mental health services (alcohol and drug treatment).
  • T codes: Used by state Medicaid agencies when there are not permanent national codes. While they can be used for private insurers, they are not valid for Medicare.

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Description

This quiz explores the various codes used for Medicare and other healthcare services. It covers specific codes like C, G, L, K, S, and H codes, highlighting their uses and significance in billing claims. Test your knowledge of these important coding systems!

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