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Official Description

Combination sit to stand frame/table system, any size including pediatric, with seat lift feature, with or without wheels
Short Descr Combination sit to stand sys
Coverage Non-covered by Medicare
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 1
IOM 100-03, 4, 240.2
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
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
RR Rental (use the 'rr' modifier when dme is to be rented)
NU New equipment
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
KX Requirements specified in the medical policy have been met
RB Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair
Date
Action
Notes
2004-01-01 Added Code added 1/1/2004
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