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Official Description

Drainage extension line, sterile, for dialysis, each
Short Descr Drainage ext line, dialysis
Coverage Special coverage instructions apply
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')
MCM 4270
BETOS P9B – Dialysis services (non-medicare fee schedule)
TOS Code(s) L – ESRD supplies
Added Date 1/1/2004
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 Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x)
MUE 0
MUE 0
IOM 100-04, 8, 90.3.2
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
Date
Action
Notes
2004-01-01 Added Code added 1/1/2004
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