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Try CasePilot| Short Descr | Als 2 | Coverage | Carrier Priced | Pricing Indicator(s) | 52 – Reasonable charge | MPI | A – Not applicable, as HCPCS priced under one methodology | BETOS | O1A – Ambulance | TOS Code(s) | D – Ambulance | Added Date | 1/1/2001 | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Service Paid under Fee Schedule or Payment System other than OPPS | MUE | 1 | MUE | Not applicable/unspecified. | OTS Orthotic | No | CCS Clinical Classification | 239 - Transportation - patient, provider, equipment |
| SH | Second concurrently administered infusion therapy | HH | Integrated mental health/substance abuse program | GW | Service not related to the hospice patient's terminal condition | RI | Ramus intermedius coronary artery | QN | Ambulance service furnished directly by a provider of services | HI | Integrated mental health and intellectual disability/developmental disabilities program | HN | Bachelors degree level | RR | Rental (use the 'rr' modifier when dme is to be rented) | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | EE | Hematocrit level has not exceeded 39% (or hemoglobin level has not exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle | GA | Waiver of liability statement issued as required by payer policy, individual case | GH | Diagnostic mammogram converted from screening mammogram on same day | GM | Multiple patients on one ambulance trip | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | HD | Pregnant/parenting women's program | HE | Mental health program | HO | Masters degree level | HP | Doctoral level | HR | Family/couple with client present | HS | Family/couple without client present | PI | Positron emission tomography (pet) or pet/computed tomography (ct) to inform the initial treatment strategy of tumors that are biopsy proven or strongly suspected of being cancerous based on other diagnostic testing | PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital | PS | Positron emission tomography (pet) or pet/computed tomography (ct) to inform the subsequent treatment strategy of cancerous tumors when the beneficiary's treating physician determines that the pet study is needed to inform subsequent anti-tumor strategy | QL | Patient pronounced dead after ambulance called | RD | Drug provided to beneficiary, but not administered "incident-to" | RP | Replacement and repair -rp may be used to indicate replacement of dme, orthotic and prosthetic devices which have been in use for sometime. the claim shows the code for the part, followed by the 'rp' modifier and the charge for the part. | SD | Services provided by registered nurse with specialized, highly technical home infusion training | SE | State and/or federally-funded programs/services | SN | Third surgical opinion | SS | Home infusion services provided in the infusion suite of the iv therapy provider | U1 | Medicaid level of care 1, as defined by each state | UA | Medicaid level of care 10, as defined by each state | UJ | Services provided at night | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter |
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| 2001-01-01 | Added | Code added 1/1/2001 |
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