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Try CasePilot| Short Descr | Manual fully reclining back | Coverage | Special coverage instructions apply | 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 | 1 | IOM | 100-03, 4, 280.1 | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | 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 | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | 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) | EY | No physician or other licensed health care provider order for this item or service | KA | Add on option/accessory for wheelchair | KH | Dmepos item, initial claim, purchase or first month rental | KI | Dmepos item, second or third 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 | 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 | UE | Used durable medical equipment |
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| 1986-01-01 | Added | Code added 1/1/1986 |
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