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Try CasePilot| Short Descr | Diphenhydramine hcl 50mg | Related Drugs | ALLERGY RELIEF | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 51 – Drugs | MPI | A – Not applicable, as HCPCS priced under one methodology | Statute | 4557 | BETOS | O1D – Chemotherapy | TOS Code(s) | 1 – Medical care | Added Date | 4/1/1998 | 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 | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | MUE | 0 | MUE | 13 | OTS Orthotic | No | CCS Clinical Classification | 240 - Medications (Injections, infusions and other forms) |
| GZ | Item or service expected to be denied as not reasonable and necessary | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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 |
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| 1998-04-01 | Added | Code added 4/1/1998 |
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