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Try CasePilot| Short Descr | Foot lamin/prepreg composite | Coverage | Carrier Priced | Pricing Indicator(s) | 00 – Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.) | MPI | 9 – Not applicable, as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99') | BETOS | D1F – Prosthetic/Orthotic devices | TOS Code(s) | P – Lump sum purchase of DME, prosthetics, orthotics | Added Date | 1/1/2004 | APC Status Indicator | Service Paid under Fee Schedule or Payment System other than OPPS | MUE | 0 | MUE | 2 | 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 | 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) | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | CR | Catastrophe/disaster related | GA | Waiver of liability statement issued as required by payer policy, individual case | GX | Notice of liability issued, voluntary under payer policy | GZ | Item or service expected to be denied as not reasonable and necessary | K3 | Lower extremity prosthesis functional level 3 - has the ability or potential for ambulation with variable cadence. typical of the community ambulator who has the ability to transverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion. | KV | Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service | KX | Requirements specified in the medical policy have been met |
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| 2004-01-01 | Added | Code added 1/1/2004 |
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