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Official Description

Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress
Short Descr Hosp bed xtra hvy dty x wide
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 60-18
BETOS D1B – Hospital beds
TOS Code(s) R – Rental of DME
Added Date 1/1/2004
APC Status Indicator Non-Implantable Durable Medical Equipment
MUE 0
MUE 1
IOM 100-03, 4, 280.7
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
RR Rental (use the 'rr' modifier when dme is to be rented)
KJ Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen
KH Dmepos item, initial claim, purchase or first month rental
GA Waiver of liability statement issued as required by payer policy, individual case
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
GZ Item or service expected to be denied as not reasonable and necessary
KI Dmepos item, second or third month rental
KX Requirements specified in the medical policy have been met
MS Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty
NU New equipment
Date
Action
Notes
2004-01-01 Added Code added 1/1/2004
Code
Description
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