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Official Description

Manual wheelchair accessory, solid seat insert
Short Descr Wheelchair solid seat insert
Coverage Carrier Priced
Pricing Indicator(s) 32 – Supplies And Surgical Dressings - Inexpensive & routinely purchased 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 1/1/1986
APC Status Indicator Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x)
MUE 0
MUE 1
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
KX Requirements specified in the medical policy have been met
RR Rental (use the 'rr' modifier when dme is to be rented)
NU New equipment
KU Dmepos item subject to dmepos competitive bidding program number 3
BP The beneficiary has been informed of the purchase and rental options and has elected to purchase the item
GA Waiver of liability statement issued as required by payer policy, individual case
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
GZ Item or service expected to be denied as not reasonable and necessary
KY Dmepos item subject to dmepos competitive bidding program number 5
LT Left side (used to identify procedures performed on the left side of the body)
RB Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair
RT Right side (used to identify procedures performed on the right side of the body)
Date
Action
Notes
1986-01-01 Added Code added 1/1/1986
Code
Description
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