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Official Description

Segmental gradient pressure pneumatic appliance, full arm
Short Descr Pressure pneum appl full arm
Coverage Special coverage instructions apply
Pricing Indicator(s) 32 – Supplies And Surgical Dressings - Inexpensive & routinely purchased DME (price subject to floors and ceilings)
MPI A – Not applicable, as HCPCS priced under one methodology
CIM 60-16
BETOS D1E – Other DME
TOS Code(s) A – Used durable medical equipment (DME)
Added Date 1/1/1995
APC Status Indicator Non-Implantable Durable Medical Equipment
MUE 0
MUE 2
IOM 100-03, 4, 280.6
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
Date
Action
Notes
1995-01-01 Added Code added 1/1/1995
Code
Description
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