The page below is a sample from the LabCE course Medicare Compliance for Clinical Laboratories. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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HCPCS and CPT Coding

The Healthcare Common Procedure Coding System (HCPCS) and the Current Procedural Terminology (CPT) codes are used to describe specific tests or services.

  • The amount of payment for a test is dependent on the HCPCS or CPT code.
  • HCPCS or CPT codes should be assigned under the supervision of the laboratory technical staff.
  • Billing department employees should never change a HCPCS or CPT code without the approval of a manager or compliance officer.
  • If a billing department clerk notices that a particular HCPCS or CPT code is being rejected by a payer they should report it to their manager.
  • It is against the law to use the wrong HCPCS or CPT code for the purpose of causing or increasing payment for a test.