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Try CasePilot| Short Descr | External ambulatory infus pu | 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 | 60-14 | BETOS | D1E – Other DME | TOS Code(s) | 9 – Other medical items or services | Added Date | 1/1/1987 | APC Status Indicator | Non-Implantable Durable Medical Equipment | MUE | 1 | MUE | 1 | IOM | 100-03, 1, 50.3 | 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 | GA | Waiver of liability statement issued as required by payer policy, individual case | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 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 | EY | No physician or other licensed health care provider order for this item or service | GW | Service not related to the hospice patient's terminal condition | GX | Notice of liability issued, voluntary under payer policy | GZ | Item or service expected to be denied as not reasonable and necessary | JB | Administered subcutaneously | NU | New equipment | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | RI | Ramus intermedius coronary artery | UE | Used durable medical equipment |
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| 1987-01-01 | Added | Code added 1/1/1987 |
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