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Try CasePilot| Short Descr | Oxygen concentrator, dual | 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 | 1/1/2004 | 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) | RA | Replacement of a dme, orthotic or prosthetic item | CR | Catastrophe/disaster related | N1 | Group 1 oxygen coverage criteria met | KX | Requirements specified in the medical policy have been met | MS | Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty | QG | Prescribed amount of stationary oxygen while at rest is greater than 4 liters per minute (lpm) |
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| 2004-01-01 | Added | Code added 1/1/2004 |
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