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Try CasePilot| Short Descr | So 8 ab rstr can/web 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 | 1/1/1982 | APC Status Indicator | Service Paid under Fee Schedule or Payment System other than OPPS | MUE | Not applicable/unspecified. | MUE | Not applicable/unspecified. | OTS Orthotic | Yes | CCS Clinical Classification | 243 - DME and supplies |
| 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) | KX | Requirements specified in the medical policy have been met | GZ | Item or service expected to be denied as not reasonable and necessary | GA | Waiver of liability statement issued as required by payer policy, individual case | CR | Catastrophe/disaster related | 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 | CG | Policy criteria applied | RA | Replacement of a dme, orthotic or prosthetic item | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CQ | Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant | EY | No physician or other licensed health care provider order for this item or service | GO | Services delivered under an outpatient occupational therapy plan of care | GP | Services delivered under an outpatient physical therapy plan of care | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GX | Notice of liability issued, voluntary under payer policy | KT | Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item | KV | Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service | NU | New equipment | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | ST | Related to trauma or injury | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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Action
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Notes
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| 2014-01-01 | Changed | Description Changed |
| 2011-01-01 | Deleted | Deleted |
| 2011-01-01 | ReActivated | This code was originally scheduled for deletion for January 1, 2011. However, on December 10, 2010, CMS issued a statement saying that it was reinstated. |
| 1982-01-01 | Added | Added |
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