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Official Description

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period
Short Descr Sup fee antiem,antica,immuno
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
CR Catastrophe/disaster related
GW Service not related to the hospice patient's terminal condition
GA Waiver of liability statement issued as required by payer policy, individual case
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
EY No physician or other licensed health care provider order for this item or service
GC This service has been performed in part by a resident under the direction of a teaching physician
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
QR Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is greater than 4 liters per minute (lpm)
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
Date
Action
Notes
2006-01-01 Added Code added 1/1/2006
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