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Try CasePilot| Short Descr | Wound cleanser any type/size | 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 |
| A1 | Dressing for one wound | KX | Requirements specified in the medical policy have been met | 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 | A2 | Dressing for two wounds | A3 | Dressing for three wounds | A4 | Dressing for four wounds | RT | Right side (used to identify procedures performed on the right side of the body) | A5 | Dressing for five wounds | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | LT | Left side (used to identify procedures performed on the left side of the body) | A9 | Dressing for nine or more wounds | 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. | A6 | Dressing for six wounds | A8 | Dressing for eight wounds | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | EY | No physician or other licensed health care provider order for this item or service | F9 | Right hand, fifth digit | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | SC | Medically necessary service or supply |
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Notes
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| 2011-01-01 | Changed | Description Changed |
| 2009-01-01 | Changed | Code description changed |
| 1997-01-01 | Added | Code added 1/1/1997 |
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