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Try CasePilot| Short Descr | Cont airway pressure device | 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 | 60-17 | BETOS | D1E – Other DME | TOS Code(s) | R – Rental of DME | Added Date | 1/1/1988 | APC Status Indicator | Non-Implantable Durable Medical Equipment | MUE | 0 | MUE | 1 | IOM | 100-03, 4, 240.2 | 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 | KI | Dmepos item, second or third month rental | KH | Dmepos item, initial claim, purchase or first month rental | KX | Requirements specified in the medical policy have been met | RA | Replacement of a dme, orthotic or prosthetic item | GZ | Item or service expected to be denied as not reasonable and necessary | 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 | BP | The beneficiary has been informed of the purchase and rental options and has elected to purchase the item | BU | The beneficiary has been informed of the purchase and rental options and after 30 days has not informed the supplier of his/her decision | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | EY | No physician or other licensed health care provider order for this item or service | GA | Waiver of liability statement issued as required by payer policy, individual case | 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 | 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. | KL | Dmepos item delivered via mail | KR | Rental item, billing for partial month | KT | Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item | KY | Dmepos item subject to dmepos competitive bidding program number 5 | N1 | Group 1 oxygen coverage criteria met | UE | Used durable medical equipment |
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| 2014-01-01 | Changed | Description Changed |
| 1988-01-01 | Added | Code added 1/1/1988 |
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