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Try CasePilot| Short Descr | Disposable male external cat | 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 | 2130 | BETOS | D1A – Medical/surgical supplies | TOS Code(s) | P – Lump sum purchase of DME, prosthetics, orthotics | Added Date | 1/1/2005 | 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 | 1 | MUE | 105 | IOM | 100-02, 15, 120 | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| KX | Requirements specified in the medical policy have been met | GA | Waiver of liability statement issued as required by payer policy, individual case | 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 | GW | Service not related to the hospice patient's terminal condition | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | GZ | Item or service expected to be denied as not reasonable and necessary | EY | No physician or other licensed health care provider order for this item or service | GK | Reasonable and necessary item/service associated with a ga or gz modifier | SC | Medically necessary service or supply | AU | Item furnished in conjunction with a urological, ostomy, or tracheostomy supply | CG | Policy criteria applied | A1 | Dressing for one wound |
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| 2005-01-01 | Added | Code added 1/1/2005 |
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