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Try CasePilot| Short Descr | Screen pap by tech w md supv | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 21 – Clinical Lab Fee Schedule - Price subject to national limitation amount | MPI | A – Not applicable, as HCPCS priced under one methodology | CIM | 50-20 | Lab Cert(s) | 630 – Cytology | Processing Note | SEE INTERMEDIARY MANUAL 3628.1A FOR PAYMENT INSTRUCTIONS. ( | BETOS | T1H – Lab tests - other (non-Medicare fee schedule) | TOS Code(s) | 5 – Diagnostic laboratory | Added Date | 1/1/1992 | 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 | CLIA Waived (QW) | No | APC Status Indicator | Service Paid under Fee Schedule or Payment System other than OPPS | MUE | 1 | MUE | Not applicable/unspecified. | IOM | 100-03, 3, 190.2 | OTS Orthotic | No | CCS Clinical Classification | 234 - Pathology |
| 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | GA | Waiver of liability statement issued as required by payer policy, individual case | GZ | Item or service expected to be denied as not reasonable and necessary | 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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| 1992-01-01 | Added | Code added 1/1/1992 |
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