| Field Name |
Field Value |
| Healthcare Common Procedure Coding System Code |
G0276 |
| HCPCS Sequence Number |
0010 |
| HCPCS Record Identification Code |
3 - First line of procedure record also contains detail information in positions 92-275 |
| HCPCS Long Description |
Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial |
| HCPCS Short Description |
Pild/placebo control clin tr |
| HCPCS Pricing Indicator Code 1 |
13 - Price established by carriers (e.G., not otherwise classified, individual determination, carrier discretion) |
| HCPCS Multiple Pricing Indicator Code |
A - Not applicable as HCPCS priced under one methodology |
| HCPCS Coverage Code |
D - Special coverage instructions apply |
| HCPCS ASC Payment Group Code |
YY |
| HCPCS ASC Payment Group Effective Date |
1/1/2015 |
| HCPCS Processing Note Number |
0193 |
| HCPCS Berenson-Eggers Type Of Service Code |
P6D - Minor procedures - other (non-Medicare fee schedule) |
| HCPCS Type Of Service Code 1 |
1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96 |
| HCPCS Anesthesia Base Unit Quantity |
0 |
| HCPCS Code Added Date |
1/1/2015 |
| HCPCS Action Effective Date |
1/1/2015 |
| HCPCS Action Code |
N - No maintenance for this code |