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Try CasePilot| Short Descr | Compression stocking bk18-30 | Coverage | Carrier Priced | Pricing Indicator(s) | 40 – | MPI | A – Not applicable, as HCPCS priced under one methodology | BETOS | O1L – | TOS Code(s) | S – Surgical dressings or other medical supplies | Added Date | 1/1/2006 | 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 | Service Paid under Fee Schedule or Payment System other than OPPS | MUE | Not applicable/unspecified. | MUE | 6 | IOM | 100-03, 4, 280.1 | 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 | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | KX | Requirements specified in the medical policy have been met | GA | Waiver of liability statement issued as required by payer policy, individual case | CR | Catastrophe/disaster related | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | GX | Notice of liability issued, voluntary under payer policy | A1 | Dressing for one wound | RA | Replacement of a dme, orthotic or prosthetic item | GP | Services delivered under an outpatient physical therapy plan of care | 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. | A2 | Dressing for two wounds | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | BL | Special acquisition of blood and blood products | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CG | Policy criteria applied | EY | No physician or other licensed health care provider order for this item or service | GC | This service has been performed in part by a resident under the direction of a teaching physician | GE | This service has been performed by a resident without the presence of a teaching physician under the primary care exception | GK | Reasonable and necessary item/service associated with a ga or gz modifier | GO | Services delivered under an outpatient occupational therapy plan of care | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | LR | Laboratory round trip | NU | New equipment | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital |
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| 2024-01-01 | Note | Change in administrative data field |
| 2006-01-01 | Added | Added |
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