AHA and CMS Establish Clearinghouse to Enhance Understanding of Health Care Common Procedure Coding System

WASHINGTON, D.C. No.151 In a joint effort to improve the quality of care available from health care providers to patients by enhancing insurance billing processes, the American Hospital Association (AHA) and the Centers for Medicare & Medicaid Services (CMS) are collaborating on a clearinghouse to address questions on better using the Healthcare Common Procedure Coding System (HCPCS).

With the implementation of prospective payment methods that use HCPCS for billing and payment by Medicare and other payors, hospitals and health care professionals face a growing need for advice on HCPCS codes. The clearinghouse, which will be managed by the AHA, will serve as a centralized point of contact to provide reliable interpretations of how established codes should be used. It will also educate hospitals, policy makers and the public on HCPCS coding.

The AHA's Central Office will handle the clearinghouse functions and provide open access to anyone with questions regarding HCPCS coding. Questions along with supporting documentation may be faxed or mailed to the AHA Central Office on HCPCS. The form to submit a question may be downloaded from the www.ahacentraloffice.org Web site. To promote further understanding and interpretations of coding, quarterly publications will be available to assist providers in properly using established HCPCS codes. Questions relating to the codes generally used to report professional services, the Current Procedural Terminology (CPT-4) Codes, will be directed to the American Medical Association. This service will be made available immediately.

Supporting the AHA clearinghouse will be an Editorial Advisory Board (EAB) for Coding Clinic for HCPCS, which is a voluntary board that includes CMS and other stakeholders in the health care community.

The HCPCS was established in 1978 by CMS to provide a standardized coding system for describing the specific items and services provided in the delivery of health care. The AHA is a not-for-profit association of health care provider organizations and individuals committed to the improvement of health in their communities.

This article originally appeared in the February 2006 issue of HME Business.

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