Medical Auditing Practice Exam

Which coding system is used for Medicare services?

1. ICD-10-CM

2. CPT®

3. HCPCS Level II

4. SNOMED CT

The correct answer is: HCPCS Level II

The coding system specifically used for Medicare services encompasses several components, but HCPCS Level II is widely recognized for its role in billing Medicare. This coding system includes codes that represent services, procedures, and supplies not covered by the CPT® codes, especially those provided by non-physician providers, such as ambulance services and durable medical equipment. While ICD-10-CM codes are utilized for diagnosis coding, and CPT® codes cover a wide range of medical procedures and services, HCPCS Level II ensures that all aspects of patient care covered by Medicare are appropriately documented and billed. SNOMED CT, on the other hand, primarily functions as a clinical terminology system for electronic health records, which is different from the billing-focused nature of HCPCS. Therefore, HCPCS Level II is essential in ensuring accurate and appropriate coding for services provided to Medicare beneficiaries, fulfilling billing requirements and ensuring that healthcare providers can be reimbursed for the services they render.