Let me try to explain this in an email. This subject happens to be a 30 minute explanation that is more confusing than a simple explanation. The opinion within this email does not represent the opinion of my employer nor of the federal government.
Within HCPCS, in a layman, simplistic viewpoint, there are 4 code labels, "Dental", "Permanent", "Temporary" and "Temporary Permanent". I will do my best to explain in as short of a paragraph as possible. Dental - These are the D-codes, They are owned and maintained by the ADA. CMS and the ADA entered into an agreement a couple of years ago allowing CMS to host the codes within HCPCS. Permanent - These codes have been approved by both the HCPCS Workgroup and the National HCPCS panel. They are codes that any payer may use, unless otherwise specified. The A-codes and B-codes are good examples. The are only permanent in the sense that they are available unless the HCPCS Panel decides to eliminate the code the following code cycle (annual). Temporary - These are codes that will definitely be eliminated with a known life-expectancy date. As an example, there are many C-codes that were implemented to meet the challenge of BBRA. The life expectancy was 2 1/2 years from the start of the project. Once the 2 1/2 years is up, they are gone. I am unsure of when this occurs but I would guess from my recollection they only have about 12 months left. G-codes are another example of this. G-codes are developed to fill a need while the code is being considered by the AMA CPT Editorial panel. Once a CPT code is implemented, the G-codes will be deleted. Temporary Permanent - While many within the HCPCS circles do not like this terminology, after the explanation, you will understand why I label these this way. These codes are ones that were developed by the HCPCS Workgroup and adopted. They are routed to the National Panel for review, but not for a vote (unless this has changed within the past 12-months). These codes are labeled temporary, yet they are permanent the same as the "permanent" codes. The marked difference between these and the permanent codes are the development process and that they generally are not allowed by Medicare. Some stats for those interested. In the year 2001, there were 4,145 HCPCS codes, 36 were deleted and nearly 6% of the codes had substantive changes from the previous year. NO HCPCS CODE IS TRULY PERMANENT. They can be modified, deleted, replaced or left alone from year-to-year. Thanks - Kurt (410) 668-1592. [EMAIL PROTECTED] > -----Original Message----- > From: Tucci-Kaufhold, Ruth A. [mailto:Ruth.Tucci-Kaufhold@;unisys.com] > Sent: Tuesday, October 22, 2002 2:55 PM > To: '[EMAIL PROTECTED]' > Subject: RE: 837 P - Local modifiers in SV1 > > > Kurt, > please clarify ... for awhile now we have been using "Level > III Local Codes" as the codes that are going away... > "Temporary codes are permanent" seems extremely confusing. I > am not a "codes" guru so I need the "elementary" explaination please. > > Ruth Tucci-Kaufhold > HIPAA Systems Analyst > UNISYS Corporation > 4050 Innslake Drive > Suite 202 > Glen Allen, VA 23060 > (804) 346-1138 > (804) 935-1647 (fax) > N246-1138 > [EMAIL PROTECTED] > > > -----Original Message----- > From: Kurt Hartmann [mailto:kurt.hartmann@;acs-inc.com] > Sent: Tuesday, October 22, 2002 1:50 PM > To: [EMAIL PROTECTED] > Subject: RE: 837 P - Local modifiers in SV1 > > > Level III codes have been extended. Please be aware, Level > III codes are not local codes. And Temporary codes are permanent. > > Thanks - Kurt > > (410) 668-1592 > [EMAIL PROTECTED] > > > > > > -----Original Message----- > > From: David Frenkel [mailto:gefeg@;att.net] > > Sent: Tuesday, October 22, 2002 12:14 PM > > To: [EMAIL PROTECTED] > > Subject: RE: 837 P - Local modifiers in SV1 > > > > > > The Consolidation Appropriations Act of 2001 extends the > > maintenance and use of official HCPCS Level III procedures > > and modifier codes deadline to Dec. 31, 2003. CMS wants > > requests for temporary national codes, including a > > justification as to why a temporary national code is needed, > > by April 1, 20003. > > < from Advance for Health Information Professionals Oct 14, 2002. > > > > > Regards, > > > > David Frenkel > > Business Development > > GEFEG USA > > Global Leader in Ecommerce Tools > > www.gefeg.com > > 425-260-5030 > > > > -----Original Message----- > > From: King, James (LNI) [mailto:KINP235@;LNI.WA.GOV] > > Sent: Tuesday, October 22, 2002 8:58 AM > > To: '[EMAIL PROTECTED]' > > Subject: RE: 837 P - Local modifiers in SV1 > > > > I know that Workers Comp programs are small players in the > > transactions, but I need to remind the group that these > > programs are exempt from HIPAA and can use local codes. So > > far the CMS has been reluctant to grant national codes for > > our local codes because of our exempt status. There has to > > be someway for you to test local codes to make sure they are > > not all stripped from the data stream. > > > > Thank you > > > > -----Original Message----- > > From: Martin Scholl [mailto:Martin.Scholl@;HIPAASuite.com] > > Sent: Wednesday, March 01, 2000 8:17 PM > > To: [EMAIL PROTECTED] > > Subject: RE: 837 P - Local modifiers in SV1 > > > > > > Yes, > > to remove local codes is one of the main goals of HIPAA > > standardization. Study the codes that are available and see > > if they don't cover your situation. If not, you could > > theoretically ask the standards body for new codes to be > > authorized, but this is a lengthy process and I wouldn't > > count on it. Martin Scholl [EMAIL PROTECTED] > > <mailto:mscholl@;martinscholl.com> www.martinscholl.com > > <http://www.martinscholl.com> 301-924-5537 Voice 301-570-0139 > > Fax 301-613-9572 Cell > > > > > > -----Original Message----- > > From: Deanna Braun [mailto:Deanna.Braun@;sharp.com] > > Sent: Monday, October 21, 2002 7:12 PM > > To: [EMAIL PROTECTED] > > Subject: 837 P - Local modifiers in SV1 > > > > > > > > > > We are currently sending 3051 claims with "local" modifiers > > for some procedures in the SV1 segment. > > > > We are in the process of testing 4010 and our certifying > > authority is rejecting the local codes. > > > > Is it true that sending these code will be considered non-compliant? > > > > Thanks for your help. > > > > > > > > > ********************************************************************** > > To be removed from this list, send a message to: > > [EMAIL PROTECTED] Please note that it may take up to 72 > > hours to process your request. > > > > > > The WEDI SNIP listserv to which you are subscribed is not > > moderated. The discussions on this listserv therefore > > represent the views of the individual participants, and do > > not necessarily represent the views of the WEDI Board of > > Directors nor WEDI SNIP. If you wish to receive an official > > opinion, post your question to the WEDI SNIP Issues Database > > at http://snip.wedi.org/tracking/. Posting of advertisements > > or other commercial use of this listserv is specifically prohibited. > > > > > > > > > > > ********************************************************************** > > To be removed from this list, send a message to: > > [EMAIL PROTECTED] Please note that it may take up to 72 > > hours to process your request. > > > > ====================================================== > > > > The WEDI SNIP listserv to which you are subscribed is not > > moderated. The discussions on this listserv therefore > > represent the views of the individual participants, and do > > not necessarily represent the views of the WEDI Board of > > Directors nor WEDI SNIP. If you wish to receive an official > > opinion, post your question to the WEDI SNIP Issues Database > > at http://snip.wedi.org/tracking/. Posting of advertisements > > or other commercial use of this listserv is specifically prohibited. > > > > > > > ********************************************************************** > > To be removed from this list, send a message to: > > [EMAIL PROTECTED] Please note that it may take up to 72 > > hours to process your request. > > > > ====================================================== > > > > The WEDI SNIP listserv to which you are subscribed is not > > moderated. The discussions on this listserv therefore > > represent the views of the individual participants, and do > > not necessarily represent the views of the WEDI Board of > > Directors nor WEDI SNIP. If you wish to receive an official > > opinion, post your question to the WEDI SNIP Issues Database > > at http://snip.wedi.org/tracking/. Posting of advertisements > > or other commercial use of this listserv is specifically prohibited. > > > > > > > > > ********************************************************************** > > To be removed from this list, send a message to: > > [EMAIL PROTECTED] Please note that it may take up to 72 > > hours to process your request. > > > > ====================================================== > > > > The WEDI SNIP listserv to which you are subscribed is not > > moderated. The discussions on this listserv therefore > > represent the views of the individual participants, and do > > not necessarily represent the views of the WEDI Board of > > Directors nor WEDI SNIP. If you wish to receive an official > > opinion, post your question to the WEDI SNIP Issues Database > > at http://snip.wedi.org/tracking/. Posting of advertisements > > or other commercial use of this listserv is specifically prohibited. > > > > > > ********************************************************************** > To be removed from this list, send a message to: [EMAIL PROTECTED] > Please note that it may take up to 72 hours to process your request. > > ====================================================== > > The WEDI SNIP listserv to which you are subscribed is not > moderated. The > discussions on this listserv therefore represent the views of > the individual > participants, and do not necessarily represent the views of > the WEDI Board > of > Directors nor WEDI SNIP. If you wish to receive an official > opinion, post > your question to the WEDI SNIP Issues Database at > http://snip.wedi.org/tracking/. > Posting of advertisements or other commercial use of this listserv is > specifically prohibited. > > > ********************************************************************** > To be removed from this list, send a message to: [EMAIL PROTECTED] > Please note that it may take up to 72 hours to process your request. > > ====================================================== > > The WEDI SNIP listserv to which you are subscribed is not > moderated. The > discussions on this listserv therefore represent the views of > the individual > participants, and do not necessarily represent the views of > the WEDI Board of > Directors nor WEDI SNIP. If you wish to receive an official > opinion, post > your question to the WEDI SNIP Issues Database at > http://snip.wedi.org/tracking/. > Posting of advertisements or other commercial use of this listserv is > specifically prohibited. > ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request. ====================================================== The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.
