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Official Description

Pharmacy supply fee for initial immunosuppressive drug(s), first month following transplant
Short Descr Dispens fee immunosupressive
Coverage Special coverage instructions apply
Pricing Indicator(s) 46 – Supplies And Surgical Dressings - Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap-filled amounts)
MPI A – Not applicable, as HCPCS priced under one methodology
Processing Note MMA section 303(e).
BETOS O1E – Other drugs
TOS Code(s) 9 – Other medical items or services
Added Date 1/1/2006
Status Code Excluded from Physician Fee Schedule by Regulation
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 Not Billable to the MAC
MUE 0
MUE 1
OTS Orthotic No
CCS Clinical Classification 240 - Medications (Injections, infusions and other forms)
KX Requirements specified in the medical policy have been met
EY No physician or other licensed health care provider order for this item or service
GW Service not related to the hospice patient's terminal condition
Date
Action
Notes
2006-01-01 Added Code added 1/1/2006
Code
Description
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