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Official Description

Continuous passive motion exercise device for use other than knee
Short Descr Cpm device, other than knee
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')
Processing Note PUBLICATION 100-03, CHAPTER 1, SECTION 280.1 (100.03, 1, 280.1).
BETOS D1E – Other DME
TOS Code(s) R – Rental of DME
Added Date 1/1/2007
APC Status Indicator Non-Covered Service, not paid under OPPS
MUE 0
MUE 0
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
RR Rental (use the 'rr' modifier when dme is to be rented)
GA Waiver of liability statement issued as required by payer policy, individual case
RT Right side (used to identify procedures performed on the right side of the body)
LT Left side (used to identify procedures performed on the left side of the body)
GZ Item or service expected to be denied as not reasonable and necessary
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
GX Notice of liability issued, voluntary under payer policy
Date
Action
Notes
2007-01-01 Added Code added 1/1/2007
Code
Description
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