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Official Description

Injection, cytarabine, 100 mg
Short Descr Cytarabine hcl 100 mg inj
Related Drugs cytarabine
Coverage Special coverage instructions apply
Pricing Indicator(s) 51 – Drugs
MPI A – Not applicable, as HCPCS priced under one methodology
MCM 2049
BETOS O1D – Chemotherapy
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 120
MUE 60
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
JW Drug amount discarded/not administered to any patient
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
KX Requirements specified in the medical policy have been met
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
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
SA Nurse practitioner rendering service in collaboration with a physician
Date
Action
Notes
2009-01-01 Changed Code description changed
1986-01-01 Added Code added 1/1/1986
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