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Try CasePilot| Short Descr | Ft arch suprt premold longit | Coverage | Special coverage instructions apply | 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') | MCM | 2323 | BETOS | D1F – Prosthetic/Orthotic devices | TOS Code(s) | P – Lump sum purchase of DME, prosthetics, orthotics | Added Date | 1/1/1982 | APC Status Indicator | Service Paid under Fee Schedule or Payment System other than OPPS | MUE | 0 | MUE | 2 | IOM | 100-02, 15, 290 | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| LT | Left side (used to identify procedures performed on the left side of the body) | 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 | RT | Right side (used to identify procedures performed on the right side of the body) | KX | Requirements specified in the medical policy have been met | GX | Notice of liability issued, voluntary under payer policy | GZ | Item or service expected to be denied as not reasonable and necessary | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | CR | Catastrophe/disaster related | EY | No physician or other licensed health care provider order for this item or service | GA | Waiver of liability statement issued as required by payer policy, individual case | GP | Services delivered under an outpatient physical therapy plan of care | GT | Via interactive audio and video telecommunication systems | GW | Service not related to the hospice patient's terminal condition | KV | Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service | LR | Laboratory round trip | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 1982-01-01 | Added | Code added 1/1/1982 |
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