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Try CasePilot| Short Descr | Pn soln nos 10 grams lipids | 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 | Processing Note | NCD MANUAL 180.2. | BETOS | O1C – Enteral and parenteral | TOS Code(s) | E – Enteral/parenteral nutrients/supplies | Added Date | 1/1/2006 | APC Status Indicator | Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x) | MUE | 0 | MUE | 15 | 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 | CR | Catastrophe/disaster related | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GX | Notice of liability issued, voluntary under payer policy | 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 | JZ | Zero drug amount discarded/not administered to any patient | EY | No physician or other licensed health care provider order for this item or service | JB | Administered subcutaneously | SC | Medically necessary service or supply | JW | Drug amount discarded/not administered to any patient | 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. | GP | Services delivered under an outpatient physical therapy plan of care | JK | One month supply or less of drug or biological | KK | Dmepos item subject to dmepos competitive bidding program number 2 | KZ | New coverage not implemented by managed care |
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| 2020-01-01 | Changed | Code description changed. |
| 2006-01-01 | Added | Code added 1/1/2006 |
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