Status Indicators

Question 1

A

Answer 1

Services furnished to a hospital outpatient that are paid under a fee schedule or payment system other than OPPS

Question 2

B

Answer 2

Codes that are not recognized by OPPS when submitted; there may be an alternative code or alternate type of bill

Question 3

C

Answer 3

Inpatient only procedures; beneficiary liable

Question 4

D

Answer 4

Discontinued codes

Question 5

E1

Answer 5

Items, codes, and services not covered by any Medicare outpatient benefit category; statutorily excluded; not reasonable and necessary

Question 6

E2

Answer 6

Items, codes, and services for which pricing information and claims data are not available

Question 7

F

Answer 7

Corneal tissue acquisition; certain CRNA services and Hepatitis B vaccines

Question 8

G

Answer 8

Pass-through Drugs and Biologicals; separate APC payment

Question 9

H

Answer 9

Pass-through device categories; separate cost-based pass-through payment, not subject to copayment

Question 10

J1

Answer 10

Hospital part B services paid through a comprehensive APC

Question 11

J2

Answer 11

Hospital part B services that may be paid through a comprehensive APC

Question 12

K

Answer 12

Nonpass-through drugs and non-implantable biologicals, including therapeutic radiopharmaceuticals

Question 13

L

Answer 13

Flu/PPV/COVID-19 vaccine; monoclonal antibody therapy product

Question 14

M

Answer 14

Items and services not billable to the FI or MAC

Question 15

N

Answer 15

Items or services packaged into APC rates

Question 16

P

Answer 16

Partial hospitalization service

Question 17

Q1

Answer 17

STV-Packaged codes

Question 18

Q2

Answer 18

T-Packaged codes

Question 19

Q3

Answer 19

Codes that may be paid through a composite APC

Question 20

Q4

Answer 20

Conditionally packaged laboratory tests

Question 21

R

Answer 21

Blood and Blood Products

Question 22

S

Answer 22

Procedure or service not subject to multiple procedure discounting

Question 23

T

Answer 23

Procedure or service subject to multiple procedure discounting

Question 24

U

Answer 24

Brachytherapy sources

Question 25

V

Answer 25

Clinic or emergency department visit

Question 26

X

Answer 26

Ancillary service

Question 27

Y

Answer 27

Non-implantable Durable Medical Equipment (DME)