| Field Name |
Field Value |
| Healthcare Common Procedure Coding System Code |
P9604 |
| 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 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
| HCPCS Short Description |
One-way allow prorated trip |
| HCPCS Pricing Indicator Code 1 |
22 - Price established by carriers (e.G., gap-fills, carrier established panels) |
| HCPCS Multiple Pricing Indicator Code |
A - Not applicable as HCPCS priced under one methodology |
| HCPCS Medicare Carriers Manual Reference Section Number 1 |
51141K |
| HCPCS Coverage Code |
D - Special coverage instructions apply |
| HCPCS Processing Note Number |
0039 |
| HCPCS Berenson-Eggers Type Of Service Code |
Y2 - Other - non-Medicare fee schedule |
| HCPCS Type Of Service Code 1 |
5 - Diagnostic laboratory |
| HCPCS Anesthesia Base Unit Quantity |
0 |
| HCPCS Code Added Date |
1/1/1987 |
| HCPCS Action Effective Date |
1/1/1992 |
| HCPCS Action Code |
N - No maintenance for this code |