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Official Description

Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial
Short Descr Thyrotropin injection
Related Drugs Thyrogen
Coverage Special coverage instructions apply
Pricing Indicator(s) 51 – Drugs
MPI A – Not applicable, as HCPCS priced under one methodology
MCM 2049
ASC Payment Group Code YY – 1/01/2008
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 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 1
MUE 0
IOM 100-02, 15, 50
OTS Orthotic No
CCS Clinical Classification 240 - Medications (Injections, infusions and other forms)
JZ Zero drug amount discarded/not administered to any patient
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 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
UD Medicaid level of care 13, as defined by each state
Date
Action
Notes
1986-01-01 Added Code added 1/1/1986
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