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Try CasePilot| Short Descr | Enteral feed sup kit grav by | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 39 – Supplies And Surgical Dressings - Parenteral and Enteral Nutrition | MPI | A – Not applicable, as HCPCS priced under one methodology | CIM | 65-10 | MCM | 2130 | BETOS | O1C – Enteral and parenteral | TOS Code(s) | E – Enteral/parenteral nutrients/supplies | Added Date | 1/1/1986 | APC Status Indicator | Non-Implantable Durable Medical Equipment | MUE | 0 | MUE | 1 | IOM | 100-02, 15, 120 | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| KX | Requirements specified in the medical policy have been met | GA | Waiver of liability statement issued as required by payer policy, individual case | 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) | GW | Service not related to the hospice patient's terminal condition | CR | Catastrophe/disaster related | EY | No physician or other licensed health care provider order for this item or service | GZ | Item or service expected to be denied as not reasonable and necessary | BO | Orally administered nutrition, not by feeding tube | GK | Reasonable and necessary item/service associated with a ga or gz modifier | GL | Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn) | GX | Notice of liability issued, voluntary under payer policy | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | JW | Drug amount discarded/not administered to any patient |
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| 2011-01-01 | Changed | Description Changed |
| 1986-01-01 | Added | Code added 1/1/1986 |
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