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Try CasePilot| Short Descr | Up ext fx orthos humeral nos | 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 | 0 | MUE | 2 | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
| RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | KX | Requirements specified in the medical policy have been met | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | CG | Policy criteria applied | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | GO | Services delivered under an outpatient occupational 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 | KV | Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service | RA | Replacement of a dme, orthotic or prosthetic item | ST | Related to trauma or injury |
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| 2015-01-01 | Changed | Short description changed |
| 1982-01-01 | Added | Added |
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