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Try CasePilot| Short Descr | W/c component-accessory nos | Coverage | Carrier Priced | Pricing Indicator(s) | 46 – Supplies And Surgical Dressings - Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap-filled amounts) | MPI | A – Not applicable, as HCPCS priced under one methodology | BETOS | D1D – Wheelchairs | TOS Code(s) | A – Used durable medical equipment (DME) | Added Date | 1/1/1994 | APC Status Indicator | Non-Implantable Durable Medical Equipment | MUE | 0 | MUE | Not applicable/unspecified. | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| NU | New equipment | RB | Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair | 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 | GA | Waiver of liability statement issued as required by payer policy, individual case | RR | Rental (use the 'rr' modifier when dme is to be rented) | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | KU | Dmepos item subject to dmepos competitive bidding program number 3 | GZ | Item or service expected to be denied as not reasonable and necessary | BP | The beneficiary has been informed of the purchase and rental options and has elected to purchase the item | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | RA | Replacement of a dme, orthotic or prosthetic item | TW | Back-up equipment | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AR | Physician provider services in a physician scarcity area | BR | The beneficiary has been informed of the purchase and rental options and has elected to rent the item | BU | The beneficiary has been informed of the purchase and rental options and after 30 days has not informed the supplier of his/her decision | CR | Catastrophe/disaster related | EY | No physician or other licensed health care provider order for this item or service | GW | Service not related to the hospice patient's terminal condition | KY | Dmepos item subject to dmepos competitive bidding program number 5 | NB | Nebulizer system, any type, fda-cleared for use with specific drug | SC | Medically necessary service or supply | U1 | Medicaid level of care 1, as defined by each state | UE | Used durable medical equipment | UR | Five patients served |
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| 1994-01-01 | Added | Code added 1/1/1994 |
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