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Try CasePilot| Short Descr | Inj. xembify, 100 mg | Related Drugs | XEMBIFY | Coverage | Carrier Priced | Pricing Indicator(s) | 51 – Drugs | MPI | A – Not applicable, as HCPCS priced under one methodology | ASC Payment Group Code | YY – 7/01/2020 | BETOS | O1E – Other drugs | TOS Code(s) | 1 – Medical care | Added Date | 7/1/2020 | Status Code | Excluded from Physician Fee Schedule by Regulation | 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 | Drugs and biologicals paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate. | MUE | 480 | MUE | 1500 | OTS Orthotic | No |
| KX | Requirements specified in the medical policy have been met | JB | Administered subcutaneously | JZ | Zero drug amount discarded/not administered to any patient | GA | Waiver of liability statement issued as required by payer policy, individual case | 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 | GX | Notice of liability issued, voluntary under payer policy | KZ | New coverage not implemented by managed care | GZ | Item or service expected to be denied as not reasonable and necessary | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | CR | Catastrophe/disaster related | JW | Drug amount discarded/not administered to any patient |
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| 2020-07-01 | Added | Code added. |
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