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Try CasePilot| Short Descr | Grad com non-elastic bk surg | 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) | P – Lump sum purchase of DME, prosthetics, orthotics | Added Date | 1/1/2009 | 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 | 0 | MUE | 2 | IOM | 10-02, 15, 100 | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| AW | Item furnished in conjunction with a surgical dressing | RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | 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 | A1 | Dressing for one wound | NU | New equipment | KX | Requirements specified in the medical policy have been met | A2 | Dressing for two wounds | 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). | A3 | Dressing for three wounds | A4 | Dressing for four wounds | A5 | Dressing for five wounds | AI | Principal physician of record | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CO | Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant | CR | Catastrophe/disaster related | 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 | GW | Service not related to the hospice patient's terminal condition | GX | Notice of liability issued, voluntary under payer policy | GZ | Item or service expected to be denied as not reasonable and necessary | KT | Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item | 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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| 2024-01-01 | Changed | Long, medium, and short descriptions changed. |
| 2009-01-01 | Added | Code Added |
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