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Try CasePilot| Short Descr | Portable gaseous 02 | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 33 – Supplies And Surgical Dressings - Oxygen and oxygen equipment (price subject to floors and ceilings) | MPI | A – Not applicable, as HCPCS priced under one methodology | CIM | 60-4 | MCM | 4107.9 | BETOS | D1C – Oxygen and supplies | TOS Code(s) | R – Rental of DME | Added Date | 1/1/1993 | 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) | KX | Requirements specified in the medical policy have been met | N1 | Group 1 oxygen coverage criteria met | CR | Catastrophe/disaster related | KT | Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item | N3 | Group 3 oxygen coverage criteria met | N2 | Group 2 oxygen coverage criteria met | QH | Oxygen conserving device is being used with an oxygen delivery system | RA | Replacement of a dme, orthotic or prosthetic item | QF | Prescribed amount of stationary oxygen while at rest exceeds 4 liters per minute (lpm) and portable oxygen is prescribed | GA | Waiver of liability statement issued as required by payer policy, individual case | GZ | Item or service expected to be denied as not reasonable and necessary | 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 | QB | Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts exceeds 4 liters per minute (lpm) and portable oxygen is prescribed | 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) | CO | Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant | EY | No physician or other licensed health care provider order for this item or service | GH | Diagnostic mammogram converted from screening mammogram on same day | GL | Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn) | 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. | KH | Dmepos item, initial claim, purchase or first month rental | KI | Dmepos item, second or third month rental | KJ | Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen | 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 | QA | Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is less than 1 liter per minute (lpm) | QE | Prescribed amount of stationary oxygen while at rest is less than 1 liter per minute (lpm) | QG | Prescribed amount of stationary oxygen while at rest is greater than 4 liters per minute (lpm) | UE | Used durable medical equipment |
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| 1993-01-01 | Added | Code added 1/1/1993 |
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