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Try CasePilot| Short Descr | Dornase alfa non-comp unit | Related Drugs | Pulmozyme | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 51 – Drugs | MPI | A – Not applicable, as HCPCS priced under one methodology | Processing Note | MEDICARE BENEFIT POLICY MANUAL, PUB 100.2, CHAPTER 15, SECTION 110.3 (100.02,15,110.3). | BETOS | D1G – Drugs Administered through DME | TOS Code(s) | 1 – Medical care | Added Date | 1/1/2000 | 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 Not Billable to the MAC | MUE | 3 | MUE | 234 | OTS Orthotic | No | CCS Clinical Classification | 240 - Medications (Injections, infusions and other forms) |
| KO | Single drug unit dose formulation | JZ | Zero drug amount discarded/not administered to any patient | 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) | 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 | EY | No physician or other licensed health care provider order for this item or service | JB | Administered subcutaneously |
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| 2009-01-01 | Changed | Code description changed |
| 2000-01-01 | Added | Code added 1/1/2000 |
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