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Try CasePilot| Short Descr | Sterile water/saline, 10 ml | Related Drugs | BACTERIOSTATIC SODIUM CHLORIDE | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 37 – Supplies And Surgical Dressings - Ostomy, tracheostomy and urological supplies (price subject to floors and ceilings) | MPI | A – Not applicable, as HCPCS priced under one methodology | MCM | 2049 | BETOS | D1F – Prosthetic/Orthotic devices | TOS Code(s) | 1 – Medical care | Added Date | 1/1/2004 | 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 | Items and Services Packaged into APC Rates | MUE | 0 | MUE | Not applicable/unspecified. | IOM | 100-02, 15, 50 | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| KX | Requirements specified in the medical policy have been met | 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 | GA | Waiver of liability statement issued as required by payer policy, individual case | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | GZ | Item or service expected to be denied as not reasonable and necessary | A1 | Dressing for one wound | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | A3 | Dressing for three wounds | CR | Catastrophe/disaster related | GW | Service not related to the hospice patient's terminal condition | A2 | Dressing for two wounds | EY | No physician or other licensed health care provider order for this item or service | AU | Item furnished in conjunction with a urological, ostomy, or tracheostomy supply | A4 | Dressing for four wounds | 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. | A6 | Dressing for six wounds | JA | Administered intravenously | SH | Second concurrently administered infusion therapy | 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. | GX | Notice of liability issued, voluntary under payer policy | JZ | Zero drug amount discarded/not administered to any patient | KY | Dmepos item subject to dmepos competitive bidding program number 5 | SQ | Item ordered by home health | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | AX | Item furnished in conjunction with dialysis services | BO | Orally administered nutrition, not by feeding tube | KD | Drug or biological infused through dme | RT | Right side (used to identify procedures performed on the right side of the body) | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | AG | Primary physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2004-01-01 | Added | Code added 1/1/2004 |
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