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Official Description

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate
Short Descr Oxygen concentrator
Coverage Special coverage instructions apply
Pricing Indicator(s) 33 – Supplies And Surgical Dressings - Oxygen and oxygen equipment (price subject to floors and ceilings)
MPI A – Not applicable, as HCPCS priced under one methodology
CIM 60-4
BETOS D1C – Oxygen and supplies
TOS Code(s) R – Rental of DME
Added Date 1/1/2000
APC Status Indicator Non-Implantable Durable Medical Equipment
MUE 0
MUE 1
IOM 100-03, 4, 240.2
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
RR Rental (use the 'rr' modifier when dme is to be rented)
KX Requirements specified in the medical policy have been met
N1 Group 1 oxygen coverage criteria met
CR Catastrophe/disaster related
KT Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item
RA Replacement of a dme, orthotic or prosthetic item
N3 Group 3 oxygen coverage criteria met
GA Waiver of liability statement issued as required by payer policy, individual case
QF Prescribed amount of stationary oxygen while at rest exceeds 4 liters per minute (lpm) and portable oxygen is prescribed
MS Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty
QH Oxygen conserving device is being used with an oxygen delivery system
N2 Group 2 oxygen coverage criteria met
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
GW Service not related to the hospice patient's terminal condition
QG Prescribed amount of stationary oxygen while at rest is greater than 4 liters per minute (lpm)
GL Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)
QA Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is less than 1 liter per minute (lpm)
QB Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts exceeds 4 liters per minute (lpm) and portable oxygen is prescribed
QE Prescribed amount of stationary oxygen while at rest is less than 1 liter per minute (lpm)
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CJ At least 20 percent but less than 40 percent impaired, limited or restricted
EA Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer chemotherapy
EY No physician or other licensed health care provider order for this item or service
K1 Lower extremity prosthesis functional level 1 - has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. typical of the limited and unlimited household ambulator.
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
KK Dmepos item subject to dmepos competitive bidding program number 2
KR Rental item, billing for partial month
KS Glucose monitor supply for diabetic beneficiary not treated with insulin
NR New when rented (use the 'nr' modifier when dme which was new at the time of rental is subsequently purchased)
NU New equipment
QC Single channel monitoring
QR Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is greater than 4 liters per minute (lpm)
QZ Crna service: without medical direction by a physician
Date
Action
Notes
2000-01-01 Added Code added 1/1/2000
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