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Try CasePilot| Short Descr | Trans bench w/wo comm open | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 00 – Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.) | MPI | 9 – Not applicable, as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99') | CIM | 60-9 | BETOS | D1E – Other DME | TOS Code(s) | A – Used durable medical equipment (DME) | Added Date | 1/1/2004 | APC Status Indicator | Non-Covered Service, not paid under OPPS | MUE | 0 | MUE | 0 | IOM | 100-03, 4, 280.1 | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| NU | New equipment | 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 | KX | Requirements specified in the medical policy have been met | BP | The beneficiary has been informed of the purchase and rental options and has elected to purchase the item | 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) | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | GZ | Item or service expected to be denied as not reasonable and necessary | KY | Dmepos item subject to dmepos competitive bidding program number 5 | RA | Replacement of a dme, orthotic or prosthetic item |
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| 2004-01-01 | Added | Code added 1/1/2004 |
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