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Official Description

Adult sized disposable incontinence product, protective brief/diaper, above extra large, each
Short Descr Adult disp brief/diap abv xl
Coverage Non-covered by Medicare
Pricing Indicator(s) 00 – Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
MPI 9 – Not applicable, as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
CIM 60-9
BETOS D1A – Medical/surgical supplies
TOS Code(s) 9 – Other medical items or services
Added Date 1/1/2007
Status Code Non-Covered Service
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
MUE Not applicable/unspecified.
MUE Not applicable/unspecified.
IOM 100-03, 4, 280.1
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
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
Date
Action
Notes
2014-01-01 Changed Description Changed
2007-01-01 Added Code added 1/1/2007
Code
Description
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