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Official Description

Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g., porcine small intestine submucosa [sis])
Short Descr Rpr intst excl anrect fist
Coverage Special coverage instructions apply
Pricing Indicator(s) 53 – Statute
MPI A – Not applicable, as HCPCS priced under one methodology
Statute 1833(t)
ASC Payment Group Code YY – 1/01/2024
BETOS P6C – Minor procedures - other (Medicare fee schedule)
TOS Code(s) 2 – Surgery
Added Date 1/1/2024
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate.
MUE 1
MUE Not applicable/unspecified.
OTS Orthotic No
Date
Action
Notes
2025-01-01 Added First appearance in codebook.
2024-01-01 Added Code added.
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