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Try CasePilot| Short Descr | Deluxe lens feature | 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') | MCM | 2130B | BETOS | D1F – Prosthetic/Orthotic devices | TOS Code(s) | Q – Vision items or services | Added Date | 1/1/2005 | 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 | APC Status Indicator | Non-Covered Service, not paid under OPPS | MUE | 0 | MUE | 0 | IOM | 100-02, 15, 120 | OTS Orthotic | No | CCS Clinical Classification | 241 - Visual aids and other optical supplies |
| LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | GA | Waiver of liability statement issued as required by payer policy, individual case | 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 | EY | No physician or other licensed health care provider order for this item or service | KX | Requirements specified in the medical policy have been met | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | EA | Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer chemotherapy | GW | Service not related to the hospice patient's terminal condition | GX | Notice of liability issued, voluntary under payer policy | GZ | Item or service expected to be denied as not reasonable and necessary | LR | Laboratory round trip |
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| 2005-01-01 | Added | Code added 1/1/2005 |
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