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Try CasePilot| Short Descr | Anchor/screw bn/bn,tis/bn | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 53 – Statute | MPI | A – Not applicable, as HCPCS priced under one methodology | Statute | 1833(T) | BETOS | D1A – Medical/surgical supplies | TOS Code(s) | 9 – Other medical items or services | Added Date | 4/1/2001 | APC Status Indicator | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | MUE | 20 | MUE | Not applicable/unspecified. | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| SG | Ambulatory surgical center (asc) facility service | 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. | TG | Complex/high tech level of care | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | HB | Adult program, non geriatric | LT | Left side (used to identify procedures performed on the left side of the body) | NU | New equipment | RT | Right side (used to identify procedures performed on the right side of the body) | T5 | Right foot, great toe | T6 | Right foot, second digit | TF | Intermediate level of care | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner |
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| 2001-04-01 | Added | Code added 4/1/2001 |
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