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Try CasePilot| Short Descr | Gastro/jejuno tube, low-pro | Coverage | Carrier Priced | Pricing Indicator(s) | 39 – Supplies And Surgical Dressings - Parenteral and Enteral Nutrition | MPI | A – Not applicable, as HCPCS priced under one methodology | BETOS | O1C – Enteral and parenteral | TOS Code(s) | E – Enteral/parenteral nutrients/supplies | Added Date | 1/1/2008 | APC Status Indicator | Non-Implantable Durable Medical Equipment | MUE | 0 | MUE | Not applicable/unspecified. | 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 | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | BO | Orally administered nutrition, not by feeding tube | UB | Medicaid level of care 11, as defined by each state | A1 | Dressing for one wound | BP | The beneficiary has been informed of the purchase and rental options and has elected to purchase the item | 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 | 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 | K1 | Lower extremity prosthesis functional level 1 - has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. typical of the limited and unlimited household ambulator. | KT | Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item | SC | Medically necessary service or supply | U3 | Medicaid level of care 3, as defined by each state | U7 | Medicaid level of care 7, as defined by each state | UC | Medicaid level of care 12, as defined by each state |
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| 2008-01-01 | Added | Code added 1/1/2008 |
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