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Official Description

Maintenance 5% wl from baseline weight in months 7-12
Short Descr 5% wl maintnd from bsline wt
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 Y1 – Other - Medicare fee schedule
TOS Code(s) 1 – Medical care
Added Date 1/1/2024
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 Not Billable to the MAC
MUE Not applicable/unspecified.
MUE Not applicable/unspecified.
OTS Orthotic No
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
VM Medicare diabetes prevention program (mdpp) virtual make-up session
Date
Action
Notes
2024-01-01 Added Code added.
Code
Description
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