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Try CasePilot| Short Descr | Pne flu hepb cov home admin | Coverage | Carrier Priced | Pricing Indicator(s) | 54 – Vaccinations | MPI | A – Not applicable, as HCPCS priced under one methodology | BETOS | O1G – Immunizations/Vaccinations | TOS Code(s) | V – Pneumococcal/flu vaccine | Added Date | 6/8/2021 | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Not Discounted when Multiple | MUE | 1 | MUE | Not applicable/unspecified. | OTS Orthotic | No |
| GW | Service not related to the hospice patient's terminal condition | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | CR | Catastrophe/disaster related | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GA | Waiver of liability statement issued as required by payer policy, individual case |
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| 2024-01-01 | Changed | Long, medium, and short descriptions changed. |
| 2021-06-09 | Changed | Long and short descriptions different than announcement. |
| 2021-06-08 | Added | Code added. |
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