APC Status Indicator Codes

The icons below are shown on the appropriate CPT® and HCPCS codes.

A  Services Paid under Fee Schedule or Payment System other than OPPS
B  Codes Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x)
C  Inpatient Procedures, not paid under OPPS
D  Discontinued Codes
E1  Non-Covered Service, not paid under OPPS
E2  Items and Services for which pricing information and claims data are not available
F  Corneal, CRNA and Hepatitis B
G  Pass-Through Drugs and Biologicals
H  Pass-Through Device Categories
J1  Hospital Part B services paid through a comprehensive APC
J2  Hospital Part B Services That May Be Paid Through a Comprehensive APC
K  Nonpass-Through Drugs and Nonimplantable Biologicals, Including Therapeutic Radiopharmaceuticals
L  Influenza Vaccine; Pneumococcal Pneumonia Vaccine
M  Items and Services Not Billable to the Fiscal Intermediary/MAC
N  Items and Services Packaged into APC Rates
P  Partial Hospitalization
Q1  STVX-Packaged Codes
Q2  T-Packaged Codes
Q3  Codes That May Be Paid Through a Composite APC
Q4  Conditionally packaged laboratory tests
R  Blood and Blood Products
S  Significant Procedure, Not Discounted When Multiple
T  Significant Procedure, Multiple Reduction Applies
U  Brachytherapy Sources
V  Clinic or Emergency Department Visit
X  Ancillary Services
Y  Non-Implantable Durable Medical Equipment


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