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Official Description

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period
Short Descr Px sup fee anti-can sub pres
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 4
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
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
GW Service not related to the hospice patient's terminal condition
GA Waiver of liability statement issued as required by payer policy, individual case
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
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
Date
Action
Notes
2009-01-01 Changed Code description changed
2006-01-01 Added Code added 1/1/2006
Code
Description
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