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Official Description

Food thickener, administered orally, per ounce
Short Descr Food thickener oral
Coverage Non-covered by Medicare
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')
CIM 60-9
BETOS Z2 – Undefined codes
TOS Code(s) E – Enteral/parenteral nutrients/supplies
Added Date 1/1/2003
APC Status Indicator Non-Covered Service, not paid under OPPS
MUE 0
MUE 0
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
BO Orally administered nutrition, not by feeding tube
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
UB Medicaid level of care 11, as defined by each state
KX Requirements specified in the medical policy have been met
GZ Item or service expected to be denied as not reasonable and necessary
GA Waiver of liability statement issued as required by payer policy, individual case
GL Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)
CR Catastrophe/disaster related
Date
Action
Notes
2003-01-01 Added Code added 1/1/2003
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