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Official Description

Customized durable medical equipment, other than wheelchair
Short Descr Cstm dme other than wheelchr
Coverage Special coverage instructions apply
Pricing Indicator(s) 45 – Supplies And Surgical Dressings - Customized DME items
MPI A – Not applicable, as HCPCS priced under one methodology
Processing Note PUB. 100-04 CH. 20 S. 30.3.
BETOS D1E – Other DME
TOS Code(s) A – Used durable medical equipment (DME)
Added Date 7/1/2013
APC Status Indicator Non-Implantable Durable Medical Equipment
MUE 0
MUE 1
OTS Orthotic No
Date
Action
Notes
2013-07-01 Added Added
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