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Try CasePilot| Short Descr | Foam drg > 48 sq in w/border | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 35 – Supplies And Surgical Dressings - Surgical dressings (price subject to floors and ceilings) | MPI | A – Not applicable, as HCPCS priced under one methodology | MCM | 2079 | BETOS | D1A – Medical/surgical supplies | TOS Code(s) | S – Surgical dressings or other medical supplies | Added Date | 1/1/1997 | 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 | Items and Services Packaged into APC Rates | MUE | 0 | MUE | Not applicable/unspecified. | IOM | 100-02, 15, 100 | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| A1 | Dressing for one wound | GW | Service not related to the hospice patient's terminal condition | A2 | Dressing for two wounds | A3 | Dressing for three wounds | A4 | Dressing for four wounds | KX | Requirements specified in the medical policy have been met | A7 | Dressing for seven wounds | 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 | A9 | Dressing for nine or more wounds | A8 | Dressing for eight wounds | A6 | Dressing for six wounds | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | LT | Left side (used to identify procedures performed on the left side of the body) | GL | Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn) | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | GZ | Item or service expected to be denied as not reasonable and necessary |
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| 2009-01-01 | Changed | Code description changed |
| 1997-01-01 | Added | Code added 1/1/1997 |
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