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Official Description

Heel loop/holder, any type, with or without ankle strap, each
Short Descr Loop heel
Coverage Carrier Priced
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')
BETOS D1D – Wheelchairs
TOS Code(s) A – Used durable medical equipment (DME)
Added Date 1/1/1986
APC Status Indicator Non-Implantable Durable Medical Equipment
MUE 0
MUE 2
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
NU New equipment
RR Rental (use the 'rr' modifier when dme is to be rented)
KX Requirements specified in the medical policy have been met
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)
KU Dmepos item subject to dmepos competitive bidding program number 3
KY Dmepos item subject to dmepos competitive bidding program number 5
RB Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair
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
KE Bid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipment
UE Used durable medical 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
BP The beneficiary has been informed of the purchase and rental options and has elected to purchase the item
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
GW Service not related to the hospice patient's terminal condition
KH Dmepos item, initial claim, purchase or first month rental
KI Dmepos item, second or third month rental
LR Laboratory round trip
SC Medically necessary service or supply
TW Back-up equipment
Date
Action
Notes
1986-01-01 Added Code added 1/1/1986
Code
Description
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