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Try CasePilot| Short Descr | Inj risankizumab-rzaa 1 mg | Related Drugs | Skyrizi | Coverage | Carrier Priced | Pricing Indicator(s) | 51 – Drugs | MPI | A – Not applicable, as HCPCS priced under one methodology | ASC Payment Group Code | YY – 1/01/2023 | BETOS | O1E – Other drugs | TOS Code(s) | 1 – Medical care | Added Date | 1/1/2023 | 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 | Pass-Through Drugs and Biologicals | ASC Payment Indicator | Drugs and biologicals paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate. | MUE | 1200 | MUE | 1200 | OTS Orthotic | No |
| JZ | Zero drug amount discarded/not administered to any patient | JA | Administered intravenously | 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 | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | EJ | Subsequent claims for a defined course of therapy, e.g., epo, sodium hyaluronate, infliximab | GW | Service not related to the hospice patient's terminal condition | CR | Catastrophe/disaster related | JG | Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes | KX | Requirements specified in the medical policy have been met | TB | Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes | JB | Administered subcutaneously |
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| 2023-01-01 | Added | Code added. |
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