Institutional Billing Resources

• Institutional Billing Codes Available from National Uniform Billing Committee (NUBC) 
• Addendums A & B — APC Groups and OPPS Payment Rates and HCPCS Codes and their Status Indicators   
• Addendum D1 — Payment Status Indicators for the Hospital Outpatient Prospective Payment System (PDF, 94 KB)
• Addendum E — Inpatient Only Procedure Codes
• Skilled Nursing Facility (SNF) Consolidated Billing (CB)

CPT and HCPCS
Current Procedural Terminology (CPT)
The CPT codes are used to report services to Medicare and other insurers and may also be referred to as Level I HCPCS. When billing CPT codes ensure that the code being used is valid for the date of service being billed. CPT is a registered trademark of the American Medical Association (AMA). To purchase a CPT book, visit the AMA website. 

Healthcare Common Procedure Coding System (HCPCS)
Level II of the HCPCS is a standardized coding system used primarily to identify products, supplies and services not included in the CPT codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, drugs and supplies (DMEPOS). To purchase a HCPCS book, visit the AMA website.

• HCPC General Information

Additional references for Coding, Coverage and Payment

• National Correct Coding Initiative Edits for Physicians and Hospital Outpatient PPS 
• CMS developed Medically Unlikely Edits (MUEs) 
• Medicare Coverage Database (National and Local Coverage Determinations)