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Try CasePilot| Short Descr | Crutch underarm pair no wood | 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 | 60-9 | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | LT | Left side (used to identify procedures performed on the left side of the body) | GA | Waiver of liability statement issued as required by payer policy, individual case | RR | Rental (use the 'rr' modifier when dme is to be rented) | RT | Right side (used to identify procedures performed on the right side of the body) | CR | Catastrophe/disaster related | PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | ET | Emergency services | 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 | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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 | KJ | Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen | 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 | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | RA | Replacement of a dme, orthotic or prosthetic item | ST | Related to trauma or injury | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | UE | Used durable medical equipment | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 1986-01-01 | Added | Code added 1/1/1986 |
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