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Official Description

Hospital observation service, per hour
Short Descr Hospital observation per hr
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')
Processing Note PAYMENT IS FOR HOSPITAL OUTPATIENT ONLY. NOT PAYABLE UNDER THE PHYSICIAN FEE SCHEDULE; IN ACCORDANCE WITH FR DATE 8/9/2002 (HOPPS), PAGE 52105.
BETOS M2A – Hospital visit - initial
TOS Code(s) 1 – Medical care
Added Date 1/1/2006
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 Not applicable/unspecified.
OTS Orthotic No
CCS Clinical Classification 237 - Ancillary Services
24 Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period: the physician or other qualified health care professional may need to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) unrelated to the original procedure. this circumstance may be reported by adding modifier 24 to the appropriate level of e/m service.
Date
Action
Notes
2006-01-01 Added Code added 1/1/2006
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Description
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