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Official Description

Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less
Short Descr Uvl pnl 2 sq ft or less
Coverage Carrier Priced
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
BETOS D1E – Other DME
TOS Code(s) A – Used durable medical equipment (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
NU New equipment
KX Requirements specified in the medical policy have been met
GA Waiver of liability statement issued as required by payer policy, individual case
GK Reasonable and necessary item/service associated with a ga or gz modifier
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
GW Service not related to the hospice patient's terminal condition
GX Notice of liability issued, voluntary under payer policy
UE Used durable medical equipment
Date
Action
Notes
2012-01-01 Changed Description Changed
2003-01-01 Added Code added 1/1/2003
Code
Description
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