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Official Description

Cane, includes canes of all materials, adjustable or fixed, with tip
Short Descr Cane adjust/fixed with tip
Coverage Special coverage instructions apply
Pricing Indicator(s) 32 – Supplies And Surgical Dressings - Inexpensive & routinely purchased DME (price subject to floors and ceilings)
MPI A – Not applicable, as HCPCS priced under one methodology
CIM 60-3
MCM 2100.1
BETOS D1E – Other DME
TOS Code(s) A – Used durable medical equipment (DME)
Added Date 1/1/1986
APC Status Indicator Non-Implantable Durable Medical Equipment
MUE 0
MUE 1
IOM 100-02, 15, 110.1
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
NU New equipment
KX Requirements specified in the medical policy have been met
GA Waiver of liability statement issued as required by payer policy, individual case
RT Right side (used to identify procedures performed on the right side of the body)
GZ Item or service expected to be denied as not reasonable and necessary
RR Rental (use the 'rr' modifier when dme is to be rented)
CR Catastrophe/disaster related
KV Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service
RA Replacement of a dme, orthotic or prosthetic item
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CG Policy criteria applied
ER Items and services furnished by a provider-based, off-campus emergency department
EY No physician or other licensed health care provider order for this item or service
GC This service has been performed in part by a resident under the direction of a teaching physician
GP Services delivered under an outpatient physical therapy plan of care
GW Service not related to the hospice patient's terminal condition
GX Notice of liability issued, voluntary under payer policy
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
KK Dmepos item subject to dmepos competitive bidding program number 2
KT Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item
KZ New coverage not implemented by managed care
LT Left side (used to identify procedures performed on the left side of the body)
ST Related to trauma or injury
UE Used durable medical equipment
UK Services provided on behalf of the client to someone other than the client (collateral relationship)
Date
Action
Notes
1986-01-01 Added Code added 1/1/1986
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