What best describes the relationship between CPT codes and HCPCS Level II codes?

• A. CPT codes report procedures and services by physicians; HCPCS Level II codes report non-physician services, supplies, equipment, and certain drugs not included in CPT
• B. CPT codes are for diagnoses; HCPCS Level II for procedures
• C. They are the same system
• D. CPT codes are used only in inpatient settings

Answer: (A)

CPT codes describe procedures and services performed by physicians, while HCPCS Level II codes cover non-physician services, supplies, equipment, and certain drugs not included in CPT. This split exists so billing can capture both the professional services provided by clinicians and the wide range of items and non-physician services used in care, such as durable medical equipment, ambulance services, and drugs not represented in CPT. CPT codes are five-digit codes developed and maintained for reporting physician procedures and related services, used across outpatient and inpatient settings. HCPCS Level II codes are alphanumeric codes (beginning with a letter) used by CMS and payers to report non-physician items and services, including DME, supplies, prosthetics, and many drugs. On a claim, you’ll often see CPT codes for the clinician’s procedures and Level II codes for the associated equipment, supplies, or non-physician services.