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Try CasePilot| Short Descr | Inj ontruzant 10 mg | Related Drugs | Ontruzant | Coverage | Carrier Priced | Pricing Indicator(s) | 51 – Drugs | MPI | A – Not applicable, as HCPCS priced under one methodology | ASC Payment Group Code | YY – 10/01/2023 | BETOS | O1E – Other drugs | TOS Code(s) | 1 – Medical care | Added Date | 7/1/2019 | 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 | Nonpass-Through Drugs and Nonimplantable Biologicals, Including Therapeutic Radiopharmaceuticals | ASC Payment Indicator | Drugs and biologicals paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate. | MUE | 120 | MUE | Not applicable/unspecified. | OTS Orthotic | No |
| JZ | Zero drug amount discarded/not administered to any patient | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services | JW | Drug amount discarded/not administered to any patient | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | TB | Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | KQ | Second or subsequent drug of a multiple drug unit dose formulation | KP | First drug of a multiple drug unit dose formulation | JA | Administered intravenously | UD | Medicaid level of care 13, as defined by each state |
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| 2023-10-01 | Note | Payment change (MOG, pricing indicator codes, anesthesia base units, Ambulatory Surgical Centers) |
| 2019-07-01 | Added | Code added. |
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