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Official Description

Intrauterine copper contraceptive
Short Descr Intraut copper contraceptive
Coverage Non-covered by Medicare statute
Pricing Indicator(s) 00 – Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
MPI 9 – Not applicable, as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
Statute 1862A1
BETOS P6C – Minor procedures - other (Medicare fee schedule)
TOS Code(s) 9 – Other medical items or services
Added Date 1/1/1986
Status Code Non-Covered Service
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 Non-Covered Service, not paid under OPPS
MUE 0
MUE Not applicable/unspecified.
OTS Orthotic No
CCS Clinical Classification 240 - Medications (Injections, infusions and other forms)
CR Catastrophe/disaster related
FP Service provided as part of family planning program
GA Waiver of liability statement issued as required by payer policy, individual case
GX Notice of liability issued, voluntary under payer policy
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
GZ Item or service expected to be denied as not reasonable and necessary
JZ Zero drug amount discarded/not administered to any patient
KY Dmepos item subject to dmepos competitive bidding program number 5
SB Nurse midwife
SE State and/or federally-funded programs/services
UD Medicaid level of care 13, as defined by each state
Date
Action
Notes
1986-01-01 Added Code added 1/1/1986
Code
Description
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