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Try CasePilot| Short Descr | Portable gas oxygen system | Coverage | Carrier Priced | Pricing Indicator(s) | 33 – Supplies And Surgical Dressings - Oxygen and oxygen equipment (price subject to floors and ceilings) | MPI | A – Not applicable, as HCPCS priced under one methodology | BETOS | D1C – Oxygen and supplies | TOS Code(s) | P – Lump sum purchase of DME, prosthetics, orthotics | Added Date | 10/1/2006 | APC Status Indicator | Non-Implantable Durable Medical Equipment | MUE | 0 | MUE | 1 | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| RR | Rental (use the 'rr' modifier when dme is to be rented) | KX | Requirements specified in the medical policy have been met | N1 | Group 1 oxygen coverage criteria met | QH | Oxygen conserving device is being used with an oxygen delivery system | GZ | Item or service expected to be denied as not reasonable and necessary | CR | Catastrophe/disaster related | QF | Prescribed amount of stationary oxygen while at rest exceeds 4 liters per minute (lpm) and portable oxygen is prescribed | RA | Replacement of a dme, orthotic or prosthetic item | N3 | Group 3 oxygen coverage criteria met | GA | Waiver of liability statement issued as required by payer policy, individual case | N2 | Group 2 oxygen coverage criteria met | KT | Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item | GW | Service not related to the hospice patient's terminal condition | GL | Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn) | 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 | KI | Dmepos item, second or third month rental | MS | Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty | NU | New equipment | QB | Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts exceeds 4 liters per minute (lpm) and portable oxygen is prescribed | QG | Prescribed amount of stationary oxygen while at rest is greater than 4 liters per minute (lpm) |
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| 2006-10-01 | Added | Code added 10/1/2006 |
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