V2790 HCPCS - AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE

Code Information

Pricing Indicator Code:
- 57 - Other carrier priced
Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
Coverage Issues Manual Reference Section Number:
N/A
Medicare Carriers Manual Reference Section Number:
N/A
Coverage Code: C - Carrier judgment

Field Name	Field Value
Healthcare Common Procedure Coding System Code	V2790
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	Amniotic membrane for surgical reconstruction, per procedure
HCPCS Short Description	Amniotic membrane
HCPCS Pricing Indicator Code 1	57 - Other carrier priced
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Coverage Code	C - Carrier judgment
HCPCS Berenson-Eggers Type Of Service Code	Z2 - Undefined codes
HCPCS Type Of Service Code 1	Q - Vision items or services
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Code Added Date	1/1/2001
HCPCS Action Effective Date	10/1/2003
HCPCS Action Code	N - No maintenance for this code