Object Description
One record per HCPCS code.
The sources for this object are AMA HCPCS and CPT Code and Modifier, and AHRQ Clinical Classifications Software (CCS) for Services and Procedures Tool (HCPCSs Level I (CPTs) and Level II), and the Ursa Standard Value Sets for helping with descriptions. (CPT copyright 2022 American Medical Association. All rights reserved.)
Ursa Studio Update Cadence: Annually
Metadata
- Table Name: ursa.mi_ursa_core_101
- Layer: METADATA_AND_INTEGRATION
- Object Type: Ursa Reference
- Temporal Class: Entity
- Case ID: HCPCS Code
- Primary Key: HCPCS Code
Published Fields
- Clinical Services Fields
- HCPCS Code -- The Healthcare Common Procedure Coding System (HCPCS) code associated with a service. Includes both HCPCS Level I codes (commonly called CPT codes) and Level II codes (which includes products, supplies, and services not included in CPT). Level II codes consist of a letter followed by four numeric digits. Current Dental Terminology codes are included in the Level II codes as HCDT. (See also [URSA-CORE] HCPCS Description)
- Short Description
- Long Description
- Work RVU
- Facility Practice Expense RVU
- Non-Facility Practice Expense RVU
- Professional Liability Insurance RVU
- Total Facility RVU
- Total Non-Facility RVU
- AHRQ CCS Single-Level Procedure Category Code
- AHRQ CCS Single-Level Procedure Category Description
- RBCS Code -- The Restructured BETOS Category System (RBCS) identifier which is comprised of 6 characters. The first character identifies the category; the second character identifies the subcategory; the third, fourth, and fifth characters identify the family, and the sixth character identifies whether the service is a major procedure.
- RBCS Category Code -- Identified as the first character of the RBCS code, categories are the highest level of the taxonomy and represent broad concepts such as “procedures,” “tests,” and “imaging.” These groupings give shape to the overall structure of the taxonomy and help guide subsequent code assignments. (See also [URSA-CORE] RBCS Code)
- RBCS Category Description
- RBCS Subcategory Code -- Identified by the combined first and second characters of the RBCS code, subcategories are the mid-level of the taxonomy, further dividing categories into specific service groups or organ 7 systems. For example, the “procedures” category contains subcategories specific to organ systems, such as “breast,” “cardiovascular,” or “skin.” The tests category contains subcategories that are specific to test type, such as “anatomic pathology” and “pulmonary function.” (See also [URSA-CORE] RBCS Code)
- RBCS Subcategory Description
- RBCS Family Code -- Families represent the lowest level of the hierarchy and subdivide the subcategories into groups of HCPCS codes based on the similarity of the procedural approach. For example, the “digestive/gastrointestinal” subcategory of the “procedures” category contains families such as “cholecystectomy – laparoscopic” and “upper GI endoscopy.” The “anatomic pathology” subcategory of the “tests” category contains families such as “immunohistochemistry” and “surgical pathology examination.” Clinical and coding experts, as well as AMA CPT section and subsection headings, are the primary means by which similar HCPCS codes are grouped. The 2022 RBCS taxonomy includes 172 named families. It is important to note that while all HCPCS codes in the RBCS taxonomy are given a category and subcategory, not all HCPCS codes are assigned to a family. The RBCS code family development process begins by identifying the highest spending among non-anesthesia HCPCS codes that, when combined, account for 90% of total allowed spending in the claims data being reviewed for the current year. These high-spend HCPCS codes (referred to below as “start codes”) are used as starting points to build RBCS code families. (See also [URSA-CORE] RBCS Code)
- RBCS Family Description
- Is RBCS Major Procedure
- Is RBCS Non-Major Procedure
- Is RBCS Non-Procedure
- Is Active HCPCS Code
- HCPCS Code Active Period Start Date
- HCPCS Code Active Period End Date
- Ursa Service Type Tier 1 Description
- BETOS Description
- Is Ursa Surgical Procedure -- If ICD-10 procedure code is in the ICD-10PCS operating room procedure value set then value = 1, else 0
- Is Ursa Non-Surgical Procedure