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Try CasePilot| Short Descr | Sumatriptan succinate / 6 mg | Related Drugs | IMITREX | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 51 – Drugs | MPI | A – Not applicable, as HCPCS priced under one methodology | MCM | 2049 | BETOS | O1E – Other drugs | TOS Code(s) | 1 – Medical care | Added Date | 1/1/1986 | 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 | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | MUE | 1 | MUE | 0 | IOM | 100-02, 15, 50 | OTS Orthotic | No | CCS Clinical Classification | 240 - Medications (Injections, infusions and other forms) |
| 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 | JZ | Zero drug amount discarded/not administered to any patient | GZ | Item or service expected to be denied as not reasonable and necessary | CR | Catastrophe/disaster related | GA | Waiver of liability statement issued as required by payer policy, individual case | JB | Administered subcutaneously | JW | Drug amount discarded/not administered to any patient | KX | Requirements specified in the medical policy have been met | SA | Nurse practitioner rendering service in collaboration with a physician | UD | Medicaid level of care 13, as defined by each state |
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| 1986-01-01 | Added | Code added 1/1/1986 |
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