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Try CasePilot| Short Descr | Cane adjust/fixed quad/3 pro | 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 | 60-15 | 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 | RR | Rental (use the 'rr' modifier when dme is to be rented) | GA | Waiver of liability statement issued as required by payer policy, individual case | 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) | GZ | Item or service expected to be denied as not reasonable and necessary | BP | The beneficiary has been informed of the purchase and rental options and has elected to purchase the item | CG | Policy criteria applied | CQ | Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant | 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 | 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 | KS | Glucose monitor supply for diabetic beneficiary not treated with insulin | KT | Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item | KV | Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service | LT | Left side (used to identify procedures performed on the left side of the body) | RA | Replacement of a dme, orthotic or prosthetic item | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 1986-01-01 | Added | Code added 1/1/1986 |
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