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Healthcare Common Procedure Coding System (HCPCS) Level I (CPT) and Level II or HCPCS procedure codes are frequently used on outpatient bills to report procedures and services performed by physicians, nonphysician practitioners, hospitals, laboratories, and outpatient facilities. The procedure code pertains to a specified revenue code and line item charge. Line item CPT or HCPCS procedure codes (CPTHCPCS) are provided by the data source. HCPCS codes are compared to a list of codes valid for the discharge date. Anticipation of or lags in response to official coding changes are permitted for discharges occurring within a window of time (six months before and six months after). HCUP validates Level I (numeric) and Level II codes (A0000-V9999) but does not validate the Level III codes (W0000-Z9999).
Beginning in data year 2019, if the line item CPT or HCPCS procedure code is not on the list of valid HCPCS codes, CPTHCPCS is set to invalid.
Also, in data year 2019, if the line item CPT or HCPCS procedure code is inconsistent with sex (ECPT02), CPTHCPCS is set to inconsistent.
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