Need help choosing the right code?
Ask CasePilot about procedures, modifiers, bundling, and coding guidance.
Try CasePilot| Short Descr | Non-adju cgm supply allow | Coverage | Carrier Priced | Pricing Indicator(s) | 34 – Supplies And Surgical Dressings - DME supplies (price subject to floors and ceilings) | MPI | A – Not applicable, as HCPCS priced under one methodology | BETOS | D1E – Other DME | TOS Code(s) | 9 – Other medical items or services | Added Date | 1/1/2023 | 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 | Non-Implantable Durable Medical Equipment | MUE | Not applicable/unspecified. | MUE | 3 | OTS Orthotic | No |
| KX | Requirements specified in the medical policy have been met | CG | Policy criteria applied | KF | Item designated by fda as class iii device | KS | Glucose monitor supply for diabetic beneficiary not treated with insulin | CR | Catastrophe/disaster related | U8 | Medicaid level of care 8, as defined by each state | GW | Service not related to the hospice patient's terminal condition | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | 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. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CF | Amcc test has been ordered by an esrd facility or mcp physician that is not part of the composite rate and is separately billable | CH | 0 percent impaired, limited or restricted | CS | Cost-sharing waived for specified covid-19 testing-related services that result in and order for or administration of a covid-19 test and/or used for cost-sharing waived preventive services furnished via telehealth in rural health clinics and federally qualified health centers during the covid-19 public health emergency | CT | Computed tomography services furnished using equipment that does not meet each of the attributes of the national electrical manufacturers association (nema) xr-29-2013 standard | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GG | Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day | GL | Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn) | KG | Dmepos item subject to dmepos competitive bidding program number 1 | KK | Dmepos item subject to dmepos competitive bidding program number 2 | KR | Rental item, billing for partial month | KU | Dmepos item subject to dmepos competitive bidding program number 3 | KY | Dmepos item subject to dmepos competitive bidding program number 5 | NU | New equipment | RA | Replacement of a dme, orthotic or prosthetic item | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2023-01-01 | Added | Code added. |
Get instant expert-level medical coding assistance.