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Try CasePilot| Short Descr | Tlso flex trnk sj-ss pre ots | Coverage | Carrier Priced | Pricing Indicator(s) | 38 – Supplies And Surgical Dressings - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) | MPI | A – Not applicable, as HCPCS priced under one methodology | BETOS | D1F – Prosthetic/Orthotic devices | TOS Code(s) | P – Lump sum purchase of DME, prosthetics, orthotics | Added Date | 1/1/2014 | APC Status Indicator | Service Paid under Fee Schedule or Payment System other than OPPS | MUE | 0 | MUE | 1 | OTS Orthotic | No |
| KX | Requirements specified in the medical policy have been met | CG | Policy criteria applied | LT | Left side (used to identify procedures performed on the left side of the body) | KV | Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service | GA | Waiver of liability statement issued as required by payer policy, individual case | J5 | Off-the-shelf orthotic subject to dmepos competitive bidding program that is furnished as part of a physical therapist or occupational therapist professional service | KT | Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item | CB | Service ordered by a renal dialysis facility (rdf) physician as part of the esrd beneficiary's dialysis benefit, is not part of the composite rate, and is separately reimbursable | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | EY | No physician or other licensed health care provider order for this item or service | GC | This service has been performed in part by a resident under the direction of a teaching physician | GP | Services delivered under an outpatient physical therapy plan of care | GW | Service not related to the hospice patient's terminal condition | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | J4 | Dmepos item subject to dmepos competitive bidding program that is furnished by a hospital upon discharge | KS | Glucose monitor supply for diabetic beneficiary not treated with insulin | KY | Dmepos item subject to dmepos competitive bidding program number 5 | NU | New equipment | RA | Replacement of a dme, orthotic or prosthetic item | RT | Right side (used to identify procedures performed on the right side of the body) | SK | Member of high risk population (use only with codes for immunization) | ST | Related to trauma or injury |
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| 2014-01-01 | Added | Added |
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