|
A4361 |
 |
Ostomy faceplate, each
| short | Ostomy face plate |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | DME | 2.0 | 3 Date of Service Edit: Clinical | Published Contractor Policy |
|
|
|
|
A4362 |
|
Skin barrier; solid, 4 x 4 or equivalent; each
| short | Solid skin barrier |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
|
A4363 |
|
Ostomy clamp, any type, replacement only, each
| short | Ostomy clamp, replacement |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | DME | 6.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
|
A4364 |
|
Adhesive, liquid or equal, any type, per oz
| short | Adhesive, liquid or equal |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
|
A4366 |
|
Ostomy vent, any type, each
| short | Ostomy vent |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4367 |
|
Ostomy belt, each
| short | Ostomy belt |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | DME | 3.0 | 3 Date of Service Edit: Clinical | Published Contractor Policy |
|
|
|
|
A4368 |
|
Ostomy filter, any type, each
| short | Ostomy filter |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4369 |
|
Ostomy skin barrier, liquid (spray, brush, etc.), per oz
| short | Skin barrier liquid per oz |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
|
A4371 |
|
Ostomy skin barrier, powder, per oz
| short | Skin barrier powder per oz |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4372 |
|
Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each
| short | Skin barrier solid 4x4 equiv |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4373 |
|
Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each
| short | Skin barrier with flange |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4375 |
|
Ostomy pouch, drainable, with faceplate attached, plastic, each
| short | Drainable plastic pch w fcpl |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4376 |
|
Ostomy pouch, drainable, with faceplate attached, rubber, each
| short | Drainable rubber pch w fcplt |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4377 |
|
Ostomy pouch, drainable, for use on faceplate, plastic, each
| short | Drainable plstic pch w/o fp |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4378 |
|
Ostomy pouch, drainable, for use on faceplate, rubber, each
| short | Drainable rubber pch w/o fp |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4379 |
|
Ostomy pouch, urinary, with faceplate attached, plastic, each
| short | Urinary plastic pouch w fcpl |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4380 |
|
Ostomy pouch, urinary, with faceplate attached, rubber, each
| short | Urinary rubber pouch w fcplt |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4381 |
|
Ostomy pouch, urinary, for use on faceplate, plastic, each
| short | Urinary plastic pouch w/o fp |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4382 |
|
Ostomy pouch, urinary, for use on faceplate, heavy plastic, each
| short | Urinary hvy plstc pch w/o fp |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4383 |
|
Ostomy pouch, urinary, for use on faceplate, rubber, each
| short | Urinary rubber pouch w/o fp |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4384 |
|
Ostomy faceplate equivalent, silicone ring, each
| short | Ostomy faceplt/silicone ring |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | DME | 4.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
|
A4385 |
|
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each
| short | Ost skn barrier sld ext wear |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4387 |
|
Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each
| short | Ost clsd pouch w att st barr |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
|
A4388 |
|
Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each
| short | Drainable pch w ex wear barr |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4389 |
|
Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each
| short | Drainable pch w st wear barr |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4390 |
|
Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each
| short | Drainable pch ex wear convex |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4391 |
|
Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each
| short | Urinary pouch w ex wear barr |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4392 |
|
Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each
| short | Urinary pouch w st wear barr |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4393 |
|
Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each
| short | Urine pch w ex wear bar conv |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4394 |
|
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce
| short | Ostomy pouch liq deodorant |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4395 |
|
Ostomy deodorant for use in ostomy pouch, solid, per tablet
| short | Ostomy pouch solid deodorant |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 3.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 3.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4396 |
|
Ostomy belt with peristomal hernia support
| short | Peristomal hernia supprt blt |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | DME | 3.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
|
A4397 |
|
Irrigation supply; sleeve, each
| short | Irrigation supply sleeve |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
|
A4398 |
|
Ostomy irrigation supply; bag, each
| short | Ostomy irrigation bag |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | DME | 1.0 | 3 Date of Service Edit: Clinical | Published Contractor Policy |
|
|
|
|
A4399 |
|
Ostomy irrigation supply; cone/catheter, with or without brush
| short | Ostomy irrig cone/cath w brs |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | DME | 1.0 | 3 Date of Service Edit: Clinical | Published Contractor Policy |
|
|
|
|
A4400 |
|
Ostomy irrigation set
| short | Ostomy irrigation set |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | DME | 0.0 | 3 Date of Service Edit: Clinical | Published Contractor Policy |
|
|
|
|
A4402 |
|
Lubricant, per ounce
| short | Lubricant per ounce |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
|
A4404 |
|
Ostomy ring, each
| short | Ostomy ring each |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4405 |
|
Ostomy skin barrier, non-pectin based, paste, per ounce
| short | Nonpectin based ostomy paste |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4406 |
|
Ostomy skin barrier, pectin-based, paste, per ounce
| short | Pectin based ostomy paste |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4407 |
|
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each
| short | Ext wear ost skn barr <=4sq" |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4408 |
|
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each
| short | Ext wear ost skn barr >4sq" |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4409 |
|
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each
| short | Ost skn barr convex <=4 sq i |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4410 |
|
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each
| short | Ost skn barr extnd >4 sq |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4411 |
|
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each
| short | Ost skn barr extnd =4sq |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4412 |
|
Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each
| short | Ost pouch drain high output |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4413 |
|
Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each
| short | 2 pc drainable ost pouch |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4414 |
|
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each
| short | Ost sknbar w/o conv<=4 sq in |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4415 |
|
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each
| short | Ost skn barr w/o conv >4 sqi |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4416 |
|
Ostomy pouch, closed, with barrier attached, with filter (1 piece), each
| short | Ost pch clsd w barrier/filtr |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4417 |
|
Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each
| short | Ost pch w bar/bltinconv/fltr |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4418 |
|
Ostomy pouch, closed; without barrier attached, with filter (1 piece), each
| short | Ost pch clsd w/o bar w filtr |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4419 |
|
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each
| short | Ost pch for bar w flange/flt |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4420 |
|
Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each
| short | Ost pch clsd for bar w lk fl |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4421 |
|
Ostomy supply; miscellaneous
| short | Ostomy supply misc |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
|
|
|
A4422 |
|
Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each
| short | Ost pouch absorbent material |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 7.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4423 |
|
Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each
| short | Ost pch for bar w lk fl/fltr |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4424 |
|
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each
| short | Ost pch drain w bar & filter |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4425 |
|
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each
| short | Ost pch drain for barrier fl |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4426 |
|
Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each
| short | Ost pch drain 2 piece system |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4427 |
|
Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each
| short | Ost pch drain/barr lk flng/f |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4428 |
|
Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each
| short | Urine ost pouch w faucet/tap |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4429 |
|
Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each
| short | Urine ost pouch w bltinconv |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4430 |
|
Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each
| short | Ost urine pch w b/bltin conv |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4431 |
|
Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each
| short | Ost pch urine w barrier/tapv |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4432 |
|
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each
| short | Os pch urine w bar/fange/tap |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4433 |
|
Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each
| short | Urine ost pch bar w lock fln |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4434 |
|
Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each
| short | Ost pch urine w lock flng/ft |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|
|
A4435 |
|
Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each
| short | 1pc ost pch drain hgh output |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup |
|
|
|