Need help choosing the right code?
Ask CasePilot about procedures, modifiers, bundling, and coding guidance.
Try CasePilot| Short Descr | Repair/svc dme non-oxygen eq | 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 | D1E – Other DME | TOS Code(s) | 9 – Other medical items or services | Added Date | 4/1/2009 | APC Status Indicator | Non-Implantable Durable Medical Equipment | MUE | Not applicable/unspecified. | MUE | Not applicable/unspecified. | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| 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 | 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) | RB | Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair | GZ | Item or service expected to be denied as not reasonable and necessary | GW | Service not related to the hospice patient's terminal condition | GX | Notice of liability issued, voluntary under payer policy | EY | No physician or other licensed health care provider order for this item or service | RA | Replacement of a dme, orthotic or prosthetic item | CR | Catastrophe/disaster related | U1 | Medicaid level of care 1, as defined by each state | BR | The beneficiary has been informed of the purchase and rental options and has elected to rent the item | GG | Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day | GL | Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn) | HY | Funded by juvenile justice agency | KE | Bid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipment | KT | Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item | KU | Dmepos item subject to dmepos competitive bidding program number 3 | LT | Left side (used to identify procedures performed on the left side of the body) | N1 | Group 1 oxygen coverage criteria met | NU | New equipment | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | RT | Right side (used to identify procedures performed on the right side of the body) | TW | Back-up equipment | U2 | Medicaid level of care 2, as defined by each state | U3 | Medicaid level of care 3, as defined by each state | U5 | Medicaid level of care 5, as defined by each state | U7 | Medicaid level of care 7, as defined by each state | UB | Medicaid level of care 11, as defined by each state |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2009-04-01 | Added | - |
Get instant expert-level medical coding assistance.