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Try CasePilot| Short Descr | Non-waterproof tape | 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 | D1F – Prosthetic/Orthotic devices | TOS Code(s) | L – ESRD supplies | Added Date | 1/1/2003 | 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, 120 | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| AW | Item furnished in conjunction with a surgical dressing | A1 | Dressing for one wound | A2 | Dressing for two wounds | AU | Item furnished in conjunction with a urological, ostomy, or tracheostomy supply | A3 | Dressing for three wounds | KX | Requirements specified in the medical policy have been met | GW | Service not related to the hospice patient's terminal condition | A4 | Dressing for four wounds | A5 | Dressing for five wounds | AV | Item furnished in conjunction with a prosthetic device, prosthetic or orthotic | 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 | A6 | Dressing for six wounds | A9 | Dressing for nine or more wounds | A7 | Dressing for seven wounds | GA | Waiver of liability statement issued as required by payer policy, individual case | A8 | Dressing for eight wounds | GZ | Item or service expected to be denied as not reasonable and necessary | UK | Services provided on behalf of the client to someone other than the client (collateral relationship) | 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. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AI | Principal physician of record | AM | Physician, team member service | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | BO | Orally administered nutrition, not by feeding tube | 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 | EY | No physician or other licensed health care provider order for this item or service | GP | Services delivered under an outpatient physical therapy plan of care | KS | Glucose monitor supply for diabetic beneficiary not treated with insulin | LT | Left side (used to identify procedures performed on the left side of the body) | NU | New equipment | RT | Right side (used to identify procedures performed on the right side of the body) | SW | Services provided by a certified diabetic educator | T5 | Right foot, great toe | U2 | Medicaid level of care 2, as defined by each state |
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| 2003-01-01 | Added | Code added 1/1/2003 |
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