HCPCS Level III
E941363
HCPCS Level III was a category of locally developed medical billing codes, often created by state Medicaid agencies or private insurers, used to report services and supplies not covered by national HCPCS Level I and II codes.
Statements (40)
| Predicate | Object |
|---|---|
| instanceOf |
healthcare reimbursement classification
ⓘ
medical billing code set ⓘ |
| alsoKnownAs |
HCPCS local codes
NERFINISHED
ⓘ
local codes ⓘ |
| appliesTo |
items not described by national HCPCS codes
ⓘ
procedures ⓘ services ⓘ supplies ⓘ |
| associatedWith |
Medicaid programs
NERFINISHED
ⓘ
Medicare administrative contractors NERFINISHED ⓘ commercial health plans ⓘ |
| classificationSystem | procedure and supply coding ⓘ |
| complements |
HCPCS Level I
ⓘ
HCPCS Level II NERFINISHED ⓘ |
| dataType | alphanumeric codes ⓘ |
| developedBy |
Medicare contractors
NERFINISHED
ⓘ
private insurers ⓘ state Medicaid agencies ⓘ |
| domain |
health insurance claims
ⓘ
medical services coding ⓘ |
| governedBy | local payer policies ⓘ |
| granularity | payer-specific detail beyond national codes ⓘ |
| maintenance | maintained by individual payers rather than a single national body ⓘ |
| notCoveredBy |
national HCPCS Level I codes
ⓘ
national HCPCS Level II codes ⓘ |
| partOf | Healthcare Common Procedure Coding System NERFINISHED ⓘ |
| purpose |
to allow payers to define additional billable services
ⓘ
to capture utilization of services unique to a region or payer ⓘ |
| regulates | reimbursement for locally defined services ⓘ |
| relatedTo |
CPT
NERFINISHED
ⓘ
HCPCS Level II NERFINISHED ⓘ |
| replacedBy | expanded use of national HCPCS Level I and II codes ⓘ |
| scope |
local or regional use
ⓘ
payer-specific use ⓘ |
| standardizationLevel | less standardized than national HCPCS codes ⓘ |
| status | discontinued as a formal HCPCS level ⓘ |
| usedFor |
healthcare claims processing
ⓘ
medical billing ⓘ reporting services and supplies not covered by national HCPCS codes ⓘ |
| usedIn | United States healthcare system NERFINISHED ⓘ |
Referenced by (1)
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