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Try CasePilot| Short Descr | Specialty care transport | 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 | 2 | MUE | Not applicable/unspecified. | OTS Orthotic | No | CCS Clinical Classification | 239 - Transportation - patient, provider, equipment |
| HH | Integrated mental health/substance abuse program | HN | Bachelors degree level | 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 | SH | Second concurrently administered infusion therapy | GW | Service not related to the hospice patient's terminal condition | HI | Integrated mental health and intellectual disability/developmental disabilities program | QN | Ambulance service furnished directly by a provider of services | HJ | Employee assistance program | HR | Family/couple with client present | 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. | HE | Mental health program | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital | RR | Rental (use the 'rr' modifier when dme is to be rented) | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | CR | Catastrophe/disaster related | EP | Service provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) program | ET | Emergency services | GA | Waiver of liability statement issued as required by payer policy, individual case | GM | Multiple patients on one ambulance trip | GN | Services delivered under an outpatient speech language pathology plan of care | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GZ | Item or service expected to be denied as not reasonable and necessary | HD | Pregnant/parenting women's program | HG | Opioid addiction treatment program | HP | Doctoral level | HS | Family/couple without client present | HX | Funded by county/local agency | JE | Administered via dialysate | NR | New when rented (use the 'nr' modifier when dme which was new at the time of rental is subsequently purchased) | 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 | QL | Patient pronounced dead after ambulance called | RI | Ramus intermedius coronary artery | 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. | 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 | U4 | Medicaid level of care 4, as defined by each state | UJ | Services provided at night |
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| 2001-01-01 | Added | Code added 1/1/2001 |
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