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Try CasePilot| Short Descr | Hiv prep, ftc/tdf 200/300mg | Related Drugs | Emtricitabine and tenofovir disoproxil fumarate | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 57 – Other carrier priced | MPI | A – Not applicable, as HCPCS priced under one methodology | MCM | 2049 | Statute | 1861(ddd) | BETOS | O1E – Other drugs | TOS Code(s) | 1 – Medical care | Added Date | 1/2/2024 | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Nonpass-Through Drugs and Nonimplantable Biologicals, Including Therapeutic Radiopharmaceuticals | ASC Payment Indicator | Unclassified drugs and biologicals; payment contractor-priced. | MUE | Not applicable/unspecified. | MUE | Not applicable/unspecified. | OTS Orthotic | No |
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| 2024-01-02 | Added | Code added. |
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