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Try CasePilot| Short Descr | Ef calorie dense>/=1.5kcal | 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 | 1/1/1984 | APC Status Indicator | Non-Implantable Durable Medical Equipment | MUE | 0 | MUE | Not applicable/unspecified. | IOM | 100-02, 15, 120 | OTS Orthotic | No | CCS Clinical Classification | 223 - Enteral and parenteral nutrition |
| KX | Requirements specified in the medical policy have been met | 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 | BO | Orally administered nutrition, not by feeding tube | 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) | GW | Service not related to the hospice patient's terminal condition | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GZ | Item or service expected to be denied as not reasonable and necessary | CR | Catastrophe/disaster related | EY | No physician or other licensed health care provider order for this item or service | KT | Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item | GK | Reasonable and necessary item/service associated with a ga or gz modifier | GX | Notice of liability issued, voluntary under payer policy | KY | Dmepos item subject to dmepos competitive bidding program number 5 | SC | Medically necessary service or supply | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | A1 | Dressing for one wound | CG | Policy criteria applied | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | JZ | Zero drug amount discarded/not administered to any patient | KG | Dmepos item subject to dmepos competitive bidding program number 1 | N1 | Group 1 oxygen coverage criteria met |
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| 1984-01-01 | Added | Code added 1/1/1984 |
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