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Try CasePilot| Short Descr | Skin seal protect moisturizr | 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 | 2079 | BETOS | D1A – Medical/surgical supplies | TOS Code(s) | L – ESRD 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 | 0 | IOM | 100-02, 15, 100 | 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 | GX | Notice of liability issued, voluntary under payer policy | KX | Requirements specified in the medical policy have been met | GZ | Item or service expected to be denied as not reasonable and necessary | A1 | Dressing for one wound | A2 | Dressing for two wounds | GA | Waiver of liability statement issued as required by payer policy, individual case | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | CG | Policy criteria applied | UA | Medicaid level of care 10, as defined by each state | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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. | A3 | Dressing for three wounds | A4 | Dressing for four wounds | A9 | Dressing for nine or more wounds | CR | Catastrophe/disaster related | GW | Service not related to the hospice patient's terminal condition | K3 | Lower extremity prosthesis functional level 3 - has the ability or potential for ambulation with variable cadence. typical of the community ambulator who has the ability to transverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion. | 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) | SC | Medically necessary service or supply | U1 | Medicaid level of care 1, as defined by each state | U8 | Medicaid level of care 8, as defined by each state | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2024-04-01 | Note | Miscellaneous change (BETOS, type of service). |
| 1997-01-01 | Added | Code added 1/1/1997 |
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