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Try CasePilot| Short Descr | Fluid circ cold pad w pump | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 36 – Supplies And Surgical Dressings - Capped rental DME (price subject to floors and ceilings) | MPI | A – Not applicable, as HCPCS priced under one methodology | CIM | 60-9 | BETOS | D1E – Other DME | TOS Code(s) | A – Used durable medical equipment (DME) | Added Date | 1/1/1997 | APC Status Indicator | Non-Implantable Durable Medical Equipment | MUE | 0 | MUE | 1 | IOM | 100-03, 4, 280.1 | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| RR | Rental (use the 'rr' modifier when dme is to be rented) | KH | Dmepos item, initial claim, purchase or first month rental | KI | Dmepos item, second or third month rental | NU | New equipment | 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) | KJ | Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen | KX | Requirements specified in the medical policy have been met | 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 | RT | Right side (used to identify procedures performed on the right side of the body) | GX | Notice of liability issued, voluntary under payer policy | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GA | Waiver of liability statement issued as required by payer policy, individual case | K1 | Lower extremity prosthesis functional level 1 - has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. typical of the limited and unlimited household ambulator. |
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| 2019-01-01 | Changed | Description Changed |
| 1997-01-01 | Added | Code added 1/1/1997 |
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