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Try CasePilot| Short Descr | W/c manual swingaway | 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 | 6 | 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 | NU | New equipment | KU | Dmepos item subject to dmepos competitive bidding program number 3 | 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 | KH | Dmepos item, initial claim, purchase or first month rental | 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 | KY | Dmepos item subject to dmepos competitive bidding program number 5 | RT | Right side (used to identify procedures performed on the right side of the body) | KE | Bid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipment | LT | Left side (used to identify procedures performed on the left side of the body) | 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 | UE | Used durable medical equipment | GZ | Item or service expected to be denied as not reasonable and necessary | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | BO | Orally administered nutrition, not by feeding tube | BR | The beneficiary has been informed of the purchase and rental options and has elected to rent the item | EY | No physician or other licensed health care provider order for this item or service | GL | Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn) | GW | Service not related to the hospice patient's terminal condition | HA | Child/adolescent program | KM | Replacement of facial prosthesis including new impression/moulage | KT | Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item | KV | Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service | MS | Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty | PB | Surgical or other invasive procedure on wrong patient | RA | Replacement of a dme, orthotic or prosthetic item | TB | Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes | TW | Back-up equipment |
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| 2004-01-01 | Added | Code added 1/1/2004 |
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