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Try CasePilot| Short Descr | Sgd accessory noc | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 46 – Supplies And Surgical Dressings - Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap-filled amounts) | MPI | A – Not applicable, as HCPCS priced under one methodology | CIM | 60-23 | BETOS | D1E – Other DME | 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 | Not applicable/unspecified. | IOM | 100-03, 1, 50.1 | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| NU | New equipment | KX | Requirements specified in the medical policy have been met | 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 | 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) | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | RB | Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair |
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| 2004-01-01 | Added | Code added 1/1/2004 |
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