| Course | HCR 201 Medical Billing and Coding (HCR/201) |
|---|---|
| Week | 4 |
| Paper type | HCPCS coding exercise |
| Length | about 858 words, 3 double-spaced pages plus title page and references |
| Format | APA 7 student paper |
| School | University of Phoenix |
| Program | BS in Health Administration |
| Updated | September 2026 |
Free sample paper for HCR 201 Week 4
Four Units of J3301 and a Right-Knee Modifier: HCPCS Level II Coding for Drugs, Supplies, Equipment and Medicare Preventive Services in a Family Practice
[Student Name]
University of Phoenix
HCR/201: Medical Billing and Coding
Week 4 Assignment
[Instructor Name]
[Date]
The patients and visits are composites written for a model coding exercise; codes and descriptors come from the HCPCS Level II code set and the federal sources listed.
What HCPCS Level II Covers
The Healthcare Common Procedure Coding System has two levels. Level I is CPT, the five-digit service codes used in last week's exercise (American Medical Association, 2025). Level II, kept up to date by the federal Medicare agency (Centers for Medicare & Medicaid Services, n.d.), covers products, supplies and services that CPT does not, such as drugs given in the office, durable medical equipment, orthotics, ambulance services and certain Medicare-specific services. Level II codes are one letter followed by four digits. The letter indicates the section: A for medical and surgical supplies, E for durable medical equipment, G for procedures and professional services, J for drugs administered other than orally, L for orthotics and prosthetics and several others.
Situation One: The Drug for Last Week's Knee Injection
Documentation: 40 mg triamcinolone acetonide injected into the right knee for osteoarthritis.
Codes: 20610-RT and J3301 × 4 units.
Reasoning: J3301 describes triamcinolone acetonide injection, not otherwise specified, per 10 mg. Forty milligrams divided by 10 milligrams is four units. The procedure code reports the injection; the J code reports the drug. Many payers, including Medicare, expect the RT modifier to identify the right side.
Situation Two: An Antibiotic Injection
Documentation: 500 mg ceftriaxone given intramuscularly to treat uncomplicated gonorrhea confirmed by testing. The drug code and the injection code travel together; either one alone tells the payer half the story.
Codes: 96372 and J0696 × 2 units.
Reasoning: J0696 is ceftriaxone sodium per 250 mg; 500 mg divided by 250 mg is two units. The intramuscular therapeutic injection is reported with CPT 96372.
Situation Three: A Medicare Wellness Visit and Influenza Vaccine
Documentation: 71-year-old Medicare patient seen for her annual wellness visit, second year. Personalized prevention plan updated. Influenza vaccine given.
Codes: G0439, G0008 and the CPT product code for the specific vaccine.
Reasoning: Medicare's annual wellness visit is a Level II service: G0438 for the first visit and G0439 for subsequent visits, and it differs from a preventive physical examination (Medicare Learning Network, n.d.). For Medicare patients, influenza vaccine administration is reported with G0008 rather than the CPT administration code, along with the vaccine product code. The diagnosis for the vaccine is Z23.
Situation Four: Crutches After an Injury
Documentation: patient with a sprained ankle given a pair of adjustable aluminum underarm crutches by the equipment supplier located in the building.
Code: E0114, billed by the supplier.
Reasoning: E0114 describes underarm crutches other than wood, pair, with pads, tips and handgrips. The practice writes the order; the supplier, enrolled with Medicare's equipment contractor, bills the code. The practice would bill it only if it were enrolled as an equipment supplier.
Situation Five: Home Glucose Test Strips
Documentation: patient with type 2 diabetes using insulin checks glucose three times daily; prescription for 100 strips a month.
Code: A4253 × 2 units, billed by the pharmacy or supplier.
Reasoning: A4253 is blood glucose test strips per 50 strips, so 100 strips are two units. The practice's role is documenting the testing frequency and the order that support coverage.
Level II Modifiers
Level II modifiers are two characters. RT and LT identify the right or left side. QW identifies a test waived under federal laboratory rules, required by Medicare for waived tests such as the rapid strep test from last week. GA indicates that a required advance beneficiary notice was given to a Medicare patient before a service Medicare may not cover, which lets the practice bill the patient if Medicare denies it.
Codes Change Every Year
Level II is updated more often than most students expect. New drug codes appear quarterly as products reach the market, descriptors change and codes are deleted. A practice that stocks a new biologic may bill it under a not-otherwise-classified code until a specific code is issued, which requires the drug name, dose and National Drug Code on the claim. The specialist checks the quarterly update each January, April, July and October and updates the practice's charge list so that retired codes are not billed.
Who Is Paid for What
Level II scenarios often involve three different billers. The practice bills for services its clinicians perform and drugs it buys and administers. Equipment suppliers bill for durable medical equipment, such as crutches, through Medicare's equipment contractors. Pharmacies bill for supplies dispensed at the counter, such as test strips, under the pharmacy or medical benefit depending on the plan. Knowing which role the practice plays prevents duplicate claims and denials.
Common Errors
The practice's last audit found three recurring HCPCS errors: one unit billed for multi-unit drug doses, drug codes billed without the administration code and the CPT influenza administration code used for Medicare patients instead of G0008.
Conclusion
HCPCS Level II fills the gaps CPT leaves: drugs, supplies, equipment and Medicare-specific services. Coding it well means reading the full descriptor, calculating units from the dose, pairing drugs with their administration, knowing which services Medicare codes differently, knowing who bills equipment and supplies and applying modifiers exactly as defined.
References
American Medical Association. (2025). CPT 2026 professional edition. American Medical Association.
Centers for Medicare & Medicaid Services. (n.d.). Healthcare Common Procedure Coding System (HCPCS). https://www.cms.gov/medicare/coding-billing/healthcare-common-procedure-system
Medicare Learning Network. (n.d.). Medicare wellness visits. Centers for Medicare & Medicaid Services. https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/preventive-services/medicare-wellness-visits.html
What the HCR 201 Week 4 instructions ask
HCR 201 Week 4 generally introduces HCPCS Level II. Students may be asked to explain the difference between Level I, which is CPT, and Level II, describe how Level II codes are organized by letter, explain who maintains the code set and when it is used and describe common Level II modifiers. Many sections include scenarios in which students assign HCPCS codes for drugs, supplies, durable medical equipment or Medicare services and explain units and modifiers. Strong answers use the full code descriptor to calculate units correctly, pair drug codes with the administration service, recognize when a Medicare-specific G code replaces a CPT code and apply modifiers only when their definitions fit.
How this HCR 201 Week 4 example is built
The exercise opens with the structure of HCPCS: CPT as Level I and a Level II set of one letter followed by four digits, maintained by the federal Medicare agency. Five situations follow, each with a short documentation excerpt, the codes and the reasoning. The knee injection from last week gains its drug code, with units calculated from a 40 milligram dose against a 10 milligram descriptor. An intramuscular antibiotic shows the same calculation. A Medicare wellness visit shows Level II codes that replace CPT codes for Medicare. Crutches and test strips show equipment and supplies billed by suppliers. A modifier section explains side, waived test and liability notice modifiers.
HCR 201 Week 4 grading rubric: where the points go
The HCPCS week is typically graded on accurate codes, correct units and sound reasoning. Instructors check that students distinguish Level I from Level II, use full code descriptors to calculate units, pair drug codes with the correct administration code, apply Medicare-specific codes where they replace CPT codes and use Level II modifiers correctly. Explaining who bills equipment and supplies and to whom earns credit. Citing the code set and federal guidance in APA format supports the work. Clear presentation of each scenario matters. Answers that report one unit regardless of dose, or that apply modifiers without meeting their definitions, usually lose points.
HCR 201 Week 4 help: mistakes to avoid
The most common HCPCS mistake in HCR 201 Week 4 is reporting one unit of a drug regardless of the dose. Divide the dose given by the amount in the code descriptor. Another is forgetting the administration code: a drug code reports the drug, not the injection. Students also use CPT codes for Medicare preventive services that have their own G codes, such as the annual wellness visit. Know which Level II codes a physician office bills and which go to equipment suppliers. Learn common modifiers and their definitions, such as RT and LT for side and GA for a signed liability notice. Check each code's current descriptor, since codes change every year. Finally, explain your reasoning.
Related HCR 201 sample papers
Other HCR 201 week samples
- HCR 201 Week 1: Coding Careers and Certification
- HCR 201 Week 2: Diagnostic Coding With ICD-10-CM
- HCR 201 Week 3: Procedure Coding With CPT
- HCR 201 Week 5: Codes in the Billing Cycle
More BS in Health Administration sample papers
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- HCIS 420 Week 4: Information System Risk Analysis
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HCR 201 Week 4 questions, answered
What does HCR/201 Week 4 usually ask for?
Many sections introduce HCPCS Level II, asking students to explain its structure, sections and modifiers and to code drugs, supplies, equipment and Medicare services in scenarios.
Where can I find a free HCR 201 Week 4 sample paper?
The five-situation HCPCS exercise is shown in full on this page without charge, with notes in the margin on units and modifiers. A first worksheet of your own scenarios can be coded free.
What is the difference between CPT and HCPCS Level II?
CPT, Level I of HCPCS, is maintained by the American Medical Association and describes procedures and services; Level II, maintained by the federal Medicare agency, describes drugs, supplies, equipment and certain services not in CPT.
How do you calculate units for J codes?
Divide the dose administered by the amount in the code descriptor and round according to payer rules; for example, 40 mg of a drug described per 10 mg is 4 units.
What does modifier GA mean?
It indicates that a required advance beneficiary notice of noncoverage was given to the Medicare patient and is on file, so the patient may be billed if Medicare denies the service.
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