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Official Description

High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each
Short Descr Hi freq chest wall oscil sys
Coverage Carrier Priced
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
BETOS D1E – Other DME
TOS Code(s) R – Rental of DME
Added Date 1/1/2003
APC Status Indicator Non-Implantable Durable Medical Equipment
MUE 0
MUE 1
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
KX Requirements specified in the medical policy have been met
KI Dmepos item, second or third month rental
KH Dmepos item, initial claim, purchase or first month rental
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
CR Catastrophe/disaster related
HT Multi-disciplinary team
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
2023-01-01 Changed First appearance of change(s) in codebook.
2022-10-01 Changed Code changed. Change in long description.
2019-01-01 Changed Description Changed
2003-01-01 Added Code added 1/1/2003
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