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Try CasePilot| Short Descr | Pad band w>=3" <5"/yd | Coverage | Carrier Priced | 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 | BETOS | D1A – Medical/surgical supplies | TOS Code(s) | S – Surgical dressings or other medical 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 | Items and Services Packaged into APC Rates | MUE | 0 | MUE | Not applicable/unspecified. | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| A1 | Dressing for one wound | A2 | Dressing for two wounds | A3 | Dressing for three wounds | KX | Requirements specified in the medical policy have been met | A4 | Dressing for four wounds | GW | Service not related to the hospice patient's terminal condition | 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 | A6 | Dressing for six wounds | A5 | Dressing for five wounds | GZ | Item or service expected to be denied as not reasonable and necessary | EY | No physician or other licensed health care provider order for this item or service | GA | Waiver of liability statement issued as required by payer policy, individual case | A7 | Dressing for seven wounds | A9 | Dressing for nine or more wounds | LT | Left side (used to identify procedures performed on the left side of the body) | A8 | Dressing for eight wounds | RT | Right side (used to identify procedures performed on the right side of the body) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) |
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| 2004-01-01 | Added | Code added 1/1/2004 |
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