| Short Descr | Bulking/spacer material impl | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 53 – Statute | MPI | A – Not applicable, as HCPCS priced under one methodology | Statute | 1833(t) | Cross-Reference(s) | 0438T | BETOS | P6C – Minor procedures - other (Medicare fee schedule) | TOS Code(s) | 2 – Surgery | Added Date | 10/1/2015 | Termination Date | 6/30/2016 | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | MUE | Not applicable/unspecified. | MUE | Not applicable/unspecified. | OTS Orthotic | No |
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Date
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Action
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Notes
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| 2016-07-01 | Deleted | Code deleted. See 0438T. |
| 2015-10-01 | Added | Added |
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