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Official Description

Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified
Short Descr Monitoring feature/devicenoc
Coverage Non-covered by Medicare statute
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')
Statute 1861(n)
BETOS T2D – Other tests - other
TOS Code(s) 9 – Other medical items or services
Added Date 1/1/2007
Status Code Not Valid for Medicare Purposes
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 Non-Covered Service, not paid under OPPS
MUE 0
MUE 0
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
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
KJ Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen
KX Requirements specified in the medical policy have been met
KI Dmepos item, second or third month rental
LT Left side (used to identify procedures performed on the left side of the body)
GW Service not related to the hospice patient's terminal condition
CR Catastrophe/disaster related
GA Waiver of liability statement issued as required by payer policy, individual case
GX Notice of liability issued, voluntary under payer policy
KH Dmepos item, initial claim, purchase or first month rental
NU New equipment
U1 Medicaid level of care 1, as defined by each state
Date
Action
Notes
2007-01-01 Added Code added 1/1/2007
Code
Description
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