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Try CasePilot| Short Descr | Corf skilled nursing service | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 99 – Value not established | 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') | Statute | 1833(a) | Processing Note | G0128 | BETOS | Y2 – Other - non-Medicare fee schedule | TOS Code(s) | 1 – Medical care | Added Date | 4/1/1998 | Status Code | Restricted Coverage | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 3 - Technical Component Only Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x) | MUE | 1 | MUE | Not applicable/unspecified. | OTS Orthotic | No | CCS Clinical Classification | 237 - Ancillary Services |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | Q8 | Two class b findings | Q9 | One class b and two class c findings | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 1998-04-01 | Added | Code added 4/1/1998 |
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