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Try CasePilot| Short Descr | Automatic bp monitor, dial | Coverage | Non-covered by Medicare | Pricing Indicator(s) | 00 – Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.) | MPI | 9 – Not applicable, as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99') | CIM | 50-42 | MCM | 4270 | Processing Note | SEE INTERMEDIARY MANUAL SECTION 3170.5 FOR COVERAGE INSTRUCTIONS PERTAINING TO | BETOS | P9B – Dialysis services (non-medicare fee schedule) | TOS Code(s) | L – ESRD supplies | Added Date | 1/1/1986 | Status Code | Non-Covered Service | 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-Covered Service, not paid under OPPS | MUE | 0 | MUE | 0 | IOM | 100-04, 8, 90.3.2 | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| 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 | AX | Item furnished in conjunction with dialysis services | GZ | Item or service expected to be denied as not reasonable and necessary | GX | Notice of liability issued, voluntary under payer policy | KX | Requirements specified in the medical policy have been met | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | 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 | GA | Waiver of liability statement issued as required by payer policy, individual case | GK | Reasonable and necessary item/service associated with a ga or gz modifier | 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) | U1 | Medicaid level of care 1, as defined by each state |
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| 1986-01-01 | Added | Code added 1/1/1986 |
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