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Official Description

Everolimus, oral, 0.25 mg
Short Descr Oral everolimus
Related Drugs Everolimus
Coverage Special coverage instructions apply
Pricing Indicator(s) 51 – Drugs
MPI A – Not applicable, as HCPCS priced under one methodology
MCM 2049.5
BETOS O1G – Immunizations/Vaccinations
TOS Code(s) 1 – Medical care
Added Date 1/1/2013
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 40
MUE 960
IOM 100-02, 15, 50
OTS Orthotic No
CCS Clinical Classification 240 - Medications (Injections, infusions and other forms)
KX Requirements specified in the medical policy have been met
GA Waiver of liability statement issued as required by payer policy, individual case
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
GW Service not related to the hospice patient's terminal condition
CR Catastrophe/disaster related
EY No physician or other licensed health care provider order for this item or service
KZ New coverage not implemented by managed care
Date
Action
Notes
2013-01-01 Added Added
Code
Description
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