| Short Descr | Inj. avsola, 10 mg | Related Drugs | AVSOLA | Coverage | Carrier Priced | Pricing Indicator(s) | 51 – Drugs | MPI | A – Not applicable, as HCPCS priced under one methodology | ASC Payment Group Code | YY – 10/01/2023 | BETOS | O1E – Other drugs | TOS Code(s) | 1 – Medical care | Added Date | 7/1/2020 | Status Code | Excluded from Physician Fee Schedule by Regulation | 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 | Nonpass-Through Drugs and Nonimplantable Biologicals, Including Therapeutic Radiopharmaceuticals | ASC Payment Indicator | Drugs and biologicals paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate. | MUE | 150 | MUE | Not applicable/unspecified. | OTS Orthotic | No |
| JZ | Zero drug amount discarded/not administered to any patient | JW | Drug amount discarded/not administered to any patient | 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 | KX | Requirements specified in the medical policy have been met | TB | Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes | JA | Administered intravenously | EJ | Subsequent claims for a defined course of therapy, e.g., epo, sodium hyaluronate, infliximab | JG | Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. |
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Date
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Action
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Notes
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|---|---|---|
| 2023-10-01 | Note | Payment change (MOG, pricing indicator codes, anesthesia base units, Ambulatory Surgical Centers) |
| 2020-07-01 | Added | Code added. |