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Try CasePilot| Short Descr | G compression garment | 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 | Not applicable/unspecified. | IOM | 100-02, 15, 130 | 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 | 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) | GA | Waiver of liability statement issued as required by payer policy, individual case | KX | Requirements specified in the medical policy have been met | GX | Notice of liability issued, voluntary under payer policy | 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). | 99 | Multiple modifiers: under certain circumstances 2 or more modifiers may be necessary to completely delineate a service. in such situations modifier 99 should be added to the basic procedure, and other applicable modifiers may be listed as part of the description of the service. | A1 | Dressing for one wound | A2 | Dressing for two wounds | A6 | Dressing for six wounds | AG | Primary physician | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | 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 | CR | Catastrophe/disaster related | EY | No physician or other licensed health care provider order for this item or service | F1 | Left hand, second digit | FA | Left hand, thumb | GO | Services delivered under an outpatient occupational therapy plan of care | GP | Services delivered under an outpatient physical therapy plan of care | GU | Waiver of liability statement issued as required by payer policy, routine notice | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary |
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Notes
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| 2024-01-01 | Changed | Long, medium, and short descriptions changed. |
| 2024-01-01 | Note | Change in administrative data field. |
| 2010-01-01 | Changed | Code description changed |
| 2006-01-01 | Added | Code added 1/1/2006 |
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