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Try CasePilot| Short Descr | Wheelchair brake extension | 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') | CIM | 60-9 | BETOS | D1D – Wheelchairs | TOS Code(s) | A – Used durable medical equipment (DME) | Added Date | 1/1/1986 | APC Status Indicator | Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x) | MUE | 0 | MUE | 2 | IOM | 100-03, 4, 280.1 | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| NU | New equipment | KX | Requirements specified in the medical policy have been met | RR | Rental (use the 'rr' modifier when dme is to be rented) | 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 | 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 | RB | Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | UE | Used durable medical equipment | BP | The beneficiary has been informed of the purchase and rental options and has elected to purchase the item | FT | Unrelated evaluation and management (e/m) visit on the same day as another e/m visit or during a global procedure (preoperative, postoperative period, or on the same day as the procedure, as applicable). (report when an e/m visit is furnished within the global period but is unrelated, or when one or more additional e/m visits furnished on the same day are unrelated) | KA | Add on option/accessory for wheelchair | KE | Bid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipment | KH | Dmepos item, initial claim, purchase or first month rental | KJ | Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen | KT | Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item | LR | Laboratory round trip | TW | Back-up equipment |
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| 1986-01-01 | Added | Code added 1/1/1986 |
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