When both a Level I and Level II code are provided to describe the same service, but the code descriptions are not identical, what should the coder do?

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Quizplus · Accepted Answer

Assigning the Level II code when it is more specific helps ensure that the coding is as accurate and detailed as possible, reflecting the exact service provided. Level II codes, often referred to as HCPCS Level II codes, are used to identify products, supplies, and services not included in the CPT codes (Level I), such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies when used outside a physician's office. When a Level II code provides a more specific description than a Level I code, using the Level II code can lead to more precise billing and, potentially, better reimbursement scenarios.

When Both a Level I and Level II Code Are