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Try CasePilot| Short Descr | Infusion pump refill kit | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 57 – Other carrier priced | MPI | A – Not applicable, as HCPCS priced under one methodology | CIM | 60-14 | Processing Note | THIS CODE MUST INCLUDE NON-CORING NEEDLES, PRESSURE MONITOR WITH STOPCOCK AND TEMPLATES. CARRIERS SHOULD NOT ALLOW SEPARATE PAYMENT FOR THIS CODE AND FOR | BETOS | D1A – Medical/surgical supplies | TOS Code(s) | P – Lump sum purchase of DME, prosthetics, orthotics | Added Date | 1/1/1994 | Status Code | Bundled/Excluded Code | 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 | 1 | MUE | Not applicable/unspecified. | IOM | 100-03, 4, 280.1 | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| GW | Service not related to the hospice patient's terminal condition | GA | Waiver of liability statement issued as required by payer policy, individual case | 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 | 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). | 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. | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | JZ | Zero drug amount discarded/not administered to any patient |
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| 1994-01-01 | Added | Code added 1/1/1994 |
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