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Try CasePilot| Short Descr | Cushioned headrest | Coverage | Carrier Priced | 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 | BETOS | D1D – Wheelchairs | TOS Code(s) | A – Used durable medical equipment (DME) | Added Date | 1/1/2004 | APC Status Indicator | Non-Implantable Durable Medical Equipment | MUE | 0 | MUE | 1 | 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 | KH | Dmepos item, initial claim, purchase or first month rental | NU | New equipment | KI | Dmepos item, second or third month rental | BP | The beneficiary has been informed of the purchase and rental options and has elected to purchase the item | KU | Dmepos item subject to dmepos competitive bidding program number 3 | KX | Requirements specified in the medical policy have been met | 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 | KY | Dmepos item subject to dmepos competitive bidding program number 5 | KE | Bid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipment | GA | Waiver of liability statement issued as required by payer policy, individual case | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | LT | Left side (used to identify procedures performed on the left side of the body) | PB | Surgical or other invasive procedure on wrong patient | SC | Medically necessary service or supply | TW | Back-up equipment | UE | Used durable medical equipment |
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| 2004-01-01 | Added | Code added 1/1/2004 |
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