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Try CasePilot| Short Descr | Ef ped hydrolyzed/amino acid | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 46 – Supplies And Surgical Dressings - Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap-filled amounts) | MPI | A – Not applicable, as HCPCS priced under one methodology | CIM | 65-10 | BETOS | O1C – Enteral and parenteral | TOS Code(s) | E – Enteral/parenteral nutrients/supplies | Added Date | 1/1/2005 | APC Status Indicator | Non-Implantable Durable Medical Equipment | MUE | 0 | MUE | Not applicable/unspecified. | IOM | 100-03, 3, 180.2 | 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 | GA | Waiver of liability statement issued as required by payer policy, individual case | BO | Orally administered nutrition, not by feeding tube | GZ | Item or service expected to be denied as not reasonable and necessary | GL | Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | EY | No physician or other licensed health care provider order for this item or service |
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| 2005-01-01 | Added | Code added 1/1/2005 |
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