Tips for Navigating the Healthcare Common Procedure Coding System Coding Process for New Devices

Obtaining an appropriate Healthcare Common Procedure Coding System (HCPCS) code for a new product is the first step in a successful reimbursement strategy. However, applying for a new HCPCS code can be a frustrating, confusing, and complex process even for those who have prepared and submitted applications many times. Although the Centers for Medicare and Medicaid Services (CMS) staff provide excellent instructions for the various steps of the process (such as completing the application and presenting at the public meetings), the uninitiated and even veterans can learn tips from those who have been involved in this process for many years. The planning for a new HCPCS code should take place well in advance before the submission actually takes place. The company's reimbursement staff should be involved early in the product research and development and clinical trial discussions. This article addresses the strategy and activities that companies should undertake before applying for a new HCPCS code. In addition, the article also addresses key milestones in the HCPCS coding process, such as completing the HCPCS code application, attending, and speaking at the HCPCS public meeting.