How it works
HCPCS Level II codes are a letter followed by four digits. J codes cover many drugs administered other than orally, E codes cover durable medical equipment, L codes cover orthotics and prosthetics, and G codes cover services Medicare defines separately from CPT, such as certain screening services. CMS updates the set quarterly. HCPCS also includes letter modifiers such as RT, LT and the X modifiers.
Why it matters
Drugs and supplies are paid by units defined in each code’s description. Billing the wrong number of units — for example, reporting milligrams instead of the code’s unit — is a common cause of under- or overpayment.
Example
A drug’s code is defined per 10 mg. A 40 mg dose is billed as 4 units. See orthopedic injections billing for how this applies in practice.