| Short Descr | Plumb/elec wk hm hemo equip | Coverage | Special coverage instructions apply | 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 | 4270 | Processing Note | SEE INTERMEDIARY MANUAL SECTION 3170.5 FOR COVERAGE INSTRUCTIONS PERTAINING TO | BETOS | P9B – Dialysis services (non-medicare fee schedule) | TOS Code(s) | L – ESRD supplies | Added Date | 1/1/1986 | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | 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 Packaged into APC Rates | MUE | 0 | MUE | 0 | IOM | 100-04, 8, 90.3.2 | OTS Orthotic | No | CCS Clinical Classification | 243 - DME and supplies |
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Date
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Action
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Notes
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| 1986-01-01 | Added | Code added 1/1/1986 |