| Short Descr | Anbx 30 prior to episode |
| Coverage | Carrier Priced |
| 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') |
| BETOS | Z2 – Undefined codes |
| TOS Code(s) | 1 – Medical care |
| Added Date | 1/1/2017 |
| Status Code | Measurement Code |
| 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 Not Billable to the MAC |
| MUE | Not applicable/unspecified. |
| MUE | Not applicable/unspecified. |
| OTS Orthotic | No |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2024-01-01 | Changed | Long description changed. |
| 2022-01-01 | Changed | Long description changed |
| 2021-01-01 | Changed | Long Description Change |
| 2017-01-01 | Added | Added |