Which of the following is mandatory for Medicare and Medicaid claims?

For Medicare and Medicaid claims, HCPCS codes are mandatory as they provide a standardized coding system specifically designed for healthcare services, supplies, and equipment that are not covered by the Current Procedural Terminology (CPT) codes. HCPCS, which stands for Healthcare Common Procedure Coding System, includes codes for products, procedures, and services that are essential for billing Medicaid and Medicare, particularly those that are not easily categorized under the CPT system.

The HCPCS codes are divided into two levels: Level I codes, which are essentially equivalent to CPT codes, and Level II codes, which address non-physician services and supplies, such as durable medical equipment, prosthetics, and certain drugs administered in outpatient settings. The importance of HCPCS coding in the billing process ensures that providers receive appropriate reimbursement for the services rendered to beneficiaries of these federal programs.

While CPT codes and ICD-10-CM codes are also essential in the broader context of healthcare documentation and billing, they do not replace the requirement of HCPCS codes specifically for Medicare and Medicaid claims. National Drug Codes can be relevant for drug billing but are not universally mandatory for all claims, thus making HCPCS codes the most comprehensive and needed for these services.