the hick pics book tends to take a bit of a back seat in medical coding and in fact a lot of curriculums don't even cover much of it at all so today i'm going to do a little overview of the higpik's book make sure you stick around to the end because i'm going to do a couple of demonstrations [Music] hey everyone i'm victoria i'm a medical coder auditor educator content creator national speaker blogger podcaster and i love coming in and publishing content for you guys to make you successful in a medical coding career so this hcpcs book a lot of coders will go through their whole curriculum and not have even opened this book we often refer to this as the hickpix book it is the healthcare common procedure coding system and is actually hypix level 2. if you've ever wondered what is level 1 of hickpix well actually cpt is technically level one of hit picks so this book that we often refer to as cpt is technically hypix level one and officially it's actually cpt-4 so what's in the heck pics book we mostly use it for things like drugs medications that we're giving it's also things like ambulance services durable medical equipment and insurance specific codes so for example capital blue cross has a specific s code that they use for their annual gyn exams medicare has g codes that they use for their annual gyn exams and there's different publishers of the hikpix book so for the cpc exam with the aapc you can use any version of hitpix that you want for the ahima exams they do have a listing of specific editions that they will permit you to use so i currently have this optum 360 version and it's kind of thin actually compared to the one that i used to have in 2018 from the coding institute now the coding institute i don't believe publishes books anymore but what i loved about this edition of it is i i used it for my coc exam and there was a lot of appendices in here like the payment status indicator caters that came in super super helpful for that exam now before i get too much into the layout of the hickpix book or at least the additions i can show you because your edition might be different i talked about how pix kind of takes this back seat in medical coding and let me talk first about the cpc exam because i know i have a lot of viewers that you're taking your cpc exam or you want to know specifically about the certification exams so when it comes to the certification exams if you look on the aapc website and you can find this by going under certification and then cpc and i'll move myself so you can kind of see it a little bit better so certification cpc and it will take you to this page and if you scroll towards the bottom of this page it will tell you everything that's going to be on the cpc exam i mean not the actual questions but the layout of the exam so this is the breakdown of how many questions are from like the 10 000 series of cpt the 30 000 series etc so if you go down here to almost the third from the bottom hit picks level two codes there are only five questions specifically two hick pics level two codes on the cpc exam now you may get some other case studies where they're kind of testing you on cpt but they might throw in you know a drug code or something too but there's only going to be five questions very specific to hick picks you could actually leave your entire hitpix book at home and probably still pass the exam if you did well on the other sections a lot of the organizations that i've worked with that have a coding department will maybe purchase one hit picks book and just share it amongst the coders because they don't use them that frequently i've even had ones where maybe i did get a hit pix book but they gave it to me maybe every other year to utilize some don't even purchase hitpix book because they utilize tools like codify and within codify or their appropriate encoder system they can search for just the hick pics code that they need so for this case this g009 is the administration code that medicare wants for medicare patients when they are having the administration of their pneumococcal vaccine so because a lot of organizations don't do a lot of hick pics coding or because the hitpix coding is kind of straightforward they don't invest in purchasing books or maybe purchasing books every single year now if you're in an organization where you build a lot of dme dme is durable medical equipment so things like casts and crutches or artificial limbs then you're going to be using a lot of hick pics codes or if you do ambulance billing you're also going to use a lot of hic pics codes as well the big thing for a majority of practices though will be doing medications and they're billed based off of certain different units so there might be 10 milligrams and maybe you administered 40 and you have to calculate and i'll show you a couple of those at the end so this is my hig picks book it's the optum 360 version it's pretty basic you don't need anything super fancy for most cases for the hickpix book starting out you'll see the table of contents the different codes they are listed alphabetically a b c d e f g etc there's also the introduction and the appendices that are available here so there is a table of drugs a lot of the codes in hick pics are drug codes and then modifiers there's a lot of modifiers that are not in your cpt book and if you're not sure where they've gotten to they're likely in your hitpix book somewhere in their modifier sections abbreviations and acronyms internet only manuals this one has hit pix changes for 2021 so that's where all the stuff has been updated since prior year place of service and type of service deleted crosswalks glossary and quality payment program so there is information here about the quality payment program the other thing to note is depending on your edition of the hicpix manual you might have more spaces in here that are blank for note taking so if you have a lot of extra notes that you're wanting to supplement in your code books for your exam take a look at your heck pics book you might have some blank pages in there that would be awesome to write some notes in and then put a little tab in there and that just says notes and maybe if there's certain abbreviations or something you can't remember you just write them on that page so part of the reason they don't cover a lot of hick pics is because it is kind of intuitive if you've already learned icd-10 and cpt here's our alphabetic index now my addition is in the front depending on your addition it might be in the back so here we start with our abdomen so abdomen dressings we have let's see here ablations we have accessories so accessories for beds accessories for total artificial hearts so a lot of supplies again and dme and insurance specific codes if you bill for wound care services and you're billing for the supplies these are some ones you might see so there are cute codes for the different types of skin replacements that are available the aloe patch aloe skin alaskan ac rt they have aloe wraps probably alloderm i imagine yep there's aloe derm so that's a popular one that i've seen a lot in skin surgeries so with our a section that starts if you think a for ambulance that's our ambulance services that's one of the big ones there things like your ambulance services outside state per mile transport we also have your als mileage per mile there's even things like specialty care transport so if you're doing ambulance billing you're going to use your higgpik's book a lot here we have things like adapters for breast pumps so more of our durable medical equipment supplies and services ostomy pouches and you can see there's headings here so these ones you can see are all your dialysis services and they're things like your catheters and needles so all of these a codes here are medical and surgical supplies we get into our next codes here these are the outpatient pps so prospective payment system here's another one for my skin fanatics application of low-cost skin substitute graft to trunk arms legs total wound surface up to 100 square centimeters first 25 square centimeters or less wound surface so again this is one we're billing for outpatient services not for the provider fee but for outpatient services and if you look down here there is a legend for what these different icons and highlights meet so the all of these green ones mean that it is special coverage instructions the ones that are highlighted in this kind of pink red non-covered by medicare yellow is carrier discretion discretion then we have quantity alert so there might be a certain quantity that is a max billable for those new code recycled reinstated our revised code and then we have here there might be an age edit a maternity edit female only male only and then these are our opps status indicators these have the different status indicators indicated by these letter indicators a through y of the opps outpatient perspective payment status indicators so those you know will need to know if you are sitting for your coc your certified outpatient coder exam what those different status indicators mean is actually in the introduction so here are the a through y opps status indicators so for example c is for inpatient procedures and then the ones that are in green though those are for ascs so ambulatory surgical center payments and then this is indications from these uh cms iom iom is their internet only manual so medicare has so many different rules and regulations it would be impossible to publish them in any sort of printed format because they're changing often they have to add new things in and they're just massive as far as volume is considered so that's for the cms iom that's what those little red indicators mean aha coding clinic if you're interested in learning more about coding clinic or cpt assist i talk about those in one of my other videos but the coding clinic is official guidance it is a paid subscription that you have to buy but they are official guidance published by the american hospital association so if you see this little purple indication like you have in here that means it is the third quarter 2012 page 8 and that is where you will find that reference for this specific code that there is going to be some guidance there in this coding clinic publication so here is the dme pos paid and then the sniff excluded that's snf everyone says that sniff that is a skilled nursing facility so next section we have here durable medical equipment walkers canes crutches and you can see we have things here in our headings like canes like crutches like attachments and then we also have codes for wheelchair accessories the next section that we have here in my orange edition is procedures professional services temporary so these are also things like insurance specific codes so this code here we just looked at we talked about this g009 administration of a pneumococcal vaccine that is the code that medicare wants to use when you are administrating a pneumo vaccine so instead of using a 90471 which is an immune immunization administration code that's in cpt we use for medicare patients this g-code we have one for flu we have one for pneuma we have one for hepatitis b when you see these g-codes you should think medicare because most often times these g-codes are medicare-specific codes so here's another one geo 101 is the cervical or vaginal cancer screening pelvic and clinical breast exam which you use instead of your female exams and capital blue cross and a lot of our blues products take s codes and for these you have to make sure that you're hitting certain criteria though like the seven of the 11 elements for a breast and pelvic exam i imagine that's probably something covered here in the coding clinics that they have referenced now this one you could almost miss these h codes are alcohol and drug abuse treatment services and then after here is our j codes this is probably the one of the biggest sections in hick pics and the are medications drugs and medications drugs administered other than oral method and then we do have some after that that are our chemotherapy drugs and these are really really important you have to have to pay attention to the different different dosages so this one is up to 10 milligrams so if you're giving seven it would still be that same because it's up to ten some of them they're build for example five milligrams so if you're giving 10 milligrams of this you would have to build two units it can easily get confusing with some of these drug codes so it's really important to pay close attention to what is the billable unit amount and then how many units are you billing because that's based off of how many you administered so if you're administering 10 the billing unit is 5 you would bill 2 units you also need to be careful because sometimes there are some that are the same medication but with different dosages so if you see this one methylprednisolone acetate 40 milligrams 80 milligrams so just because you have an 80 milligram dose you can't just assume that it's going to be two of these because there might be another code that has a full 80 milligram dose after that there's a tiny section of just temporary codes and then we go into orthotic devices and procedures so different orthotic equipment for your legs for your knees even things like orthopedic footwear are in the section and then after that we get into some q codes these q are also temporary codes i've seen some different insurances that prefer these q codes there's some for like pap collections for medicare that they want right there q zero zero nine one screening perpendicular smear obtaining preparing and conveyance of cervical vaginal smears to the laboratory so there some of them will get paid by insurances maybe not all of them um if you find a hit picks code for it that's another thing to consider there are some diagnostic radiology services here in the r codes are for radiology and then we get into our s codes s is a lot of at least from my experience things that capital blue cross and blues programs pays for so here is our home infusion therapies um i've seen some for like annual gyn exams what else have we gotten here i can show you diabetic retinol eye exams performance measurements evaluation of patient self assessment for depression so these are ones that some carriers might pay for and then we have our national codes so these are the ones that start out with tea so the national codes that are established for state medicaid agencies and then we get into our v codes so these are some of our vision services v for vision kind of intuitive right so bifocals and glasses and contact lenses after that on my edition is my table of drugs and biologicals so say for example i'm doing an administration of 40 milligrams of kenalog i would go in here and i would look up kenalog so here is catalog 10 it's billed by 10 milligrams intramuscular j3301 so if i'm billing for that i'm going to have to figure out how many units am i going to bill if i'm doing that 10 milligrams intramuscularly j3301 so let's take a look at j3301 so here's j3301 it gives the long proper chemical name but then it does give you the brand names down here use this for catalog 10 catalog 40 etc etc so this is per 10 milligrams so if i was billing for 40 milligrams i would have to build j3301 times four to account for 40 milligrams because you have to do just a little bit of math there so 40 divided by 10 would be four so four units now here for appendix two is the modifiers so there's some modifiers you may see reference that aren't going to appear in your cpt book but there they are sure enough they are in your hicpix manual you can check in that appendix too and again if you have a different edition they might have a different appendices or list them differently it might be appendix abc but this is where you can find all of the additional modifiers so for example if you're looking for the ga modifier for our abn patients so if they're having an advanced beneficiary notice signed and you're looking for that ga modifier here it is medicare waiver of liability statement issued as required by payer policy individual case so you might find some more here like if you work with residents you're probably going to get familiar with the gc modifier this service has been performed by a resident under the direction of a teaching physician and then my appendices 3 has abbreviations and acronyms some greater than less than equal to if it tells you that ekg stands for electrocardiogram so something to get familiar with if you're taking your exam four is the medicare internet only manual so it just talks a little bit about what that is and how often they publish revisions etc then five is your hick picks changes for 2021 so if you've got your brand new book and you want to go oh did any of the codes that i used change you can check right there in this appendices six is place of service and type of service now most of these are also in your cpt book so if you grab your cpt book and you look here in that right after that front flap you'll have your place of service codes here as well and this is also in your hick pics book then in this appendices and then we have seven is the deleted code crosswalks and then eight i have a glossary just some typical terms that you might use in heck pics there's a lot of glossary terms in here and then like i talked about notes section look at this look at this real estate you've got over here in your hic pics book holy crow so you could write a ton of notes a ton of notes in your hic pics book and then the great thing about that is and since most of the questions aren't going to have your hick pics book needed for them for the code lookup you could be looking at your cpt book or looking at your icd-10-cm book and then just going oh here's where i wrote my notes about blah blah blah abbreviations or illustrations or all kinds of look at all these look at that look at that look at that tons of note space there's no need to to supplement or tape pages in when you've got tons of real estate here in your hikpix book now just to demonstrate how different some of the book editions are this is my 2018 tci book now again i don't believe tci is publishing books anymore they kind of merged in with aapc because they're part of the same uh parent company so this one it actually puts all the cpt modifiers in here and then the different hic pics modifiers are on the bottom as well this one has a little flap so in here it starts very similar with the so this starts pretty similar with the table of contents and then just some information about it it has symbols it has instructions for using but then it gets actually in this edition a lot into the information just about hit picks so there's tons of different stuff in here about requesting revisions this actually has the new codes and revised and deleted codes in the front and then there's actually some of the information that's in the appendices in the back of my other one is in the front here and then there's a lot of anatomical illustrations in this edition so you might be able to find some more robust take pics versions that also have some anatomical illustrations in them as well so after the anatomical illustrations is when it actually starts then getting into that alphabetic hypix index so going into the you know adapters and adhesives etc now after that it's all fairly similar fairly fairly similar as far as you know the different sections uh this one is actually a bigger print than the other one i have which was also nice but then we get into after the end of that are appendices and this one has kind of different appendices in it it starts out fairly the same it's the table of drugs and biologicals but then we start getting into modifiers and then these actually have things like here the appendices instead of being one two three four are letters so so this one actually has this appendix e in it that is the asc payment indicators now the other addition you saw there were those little icons on the bottom that kind of indicated some of the payment status indicators now that i don't know if it's in this book as well yeah it looks like this one does have the payment status indicators differentiated in different colors so here in the red you see a3y is the apc status indicators and this one here has an m so that would be status indicator m but this one's nice because it has all the indicators listed and then has this whole appendix f with the asc payment indicators in it there's also some of the cci edits in this the column one and column two correct coding initiative edits and part of what made this book more bulky is there's a lot of information from the cms internet only manual specific to these codes in the back in one of the appendices let's do one more demonstration so if i'm looking for an artificial eye so a prosthetic eye i would go into my alphabetic section here and i would look for the word p for prosthetic so let's see here p pressure probe prosthesis so i'm going to zoom you guys do you feel like you just zoomed right in there with me prosthesis of the eye so it's giving us a variety of different options here there's c1839 l8610v2623 and v through v2629 so let's take a look at c1839 so this is an iris prosthesis not exactly what we're looking for so our next one would be the l8610 so l8610 is an ocular implant that might be what we're looking for but let's also take a look at what these v codes are v2623 prosthetic eye plastic custom so that would be the right code if we're doing a plastic eye placement we also have here some of these other codes or prosthetic eye other types so maybe if it's a glass eye this would be the appropriate ones that we could use there's also scleral cover shell reduction of an ocular prosthesis so let's say for argument's sake we double checked the documentation and it says it is a prosthetic plastic eye in that case this is the code we would use the v2623 for that prosthetic eye plastic custom so that is my review of the hickpix book or healthcare common procedural coding system level 2. i hope you found this video helpful if you did make sure you leave me a comment in the comments below i will see you guys in the next video and until then you just keep on coding on