APC Status Indicator Codes
The icons below are shown on the appropriate CPT® and HCPCS codes.Services Paid under Fee Schedule or Payment System other than OPPS | |
Codes Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x) | |
Inpatient Procedures, not paid under OPPS | |
Discontinued Codes | |
Non-Covered Service, not paid under OPPS | |
Items and Services for which pricing information and claims data are not available | |
Corneal, CRNA and Hepatitis B | |
Pass-Through Drugs and Biologicals | |
Pass-Through Device Categories | |
Hospital Part B services paid through a comprehensive APC | |
Hospital Part B Services That May Be Paid Through a Comprehensive APC | |
Nonpass-Through Drugs and Nonimplantable Biologicals, Including Therapeutic Radiopharmaceuticals | |
Influenza Vaccine; Pneumococcal Pneumonia Vaccine | |
Items and Services Not Billable to the Fiscal Intermediary/MAC | |
Items and Services Packaged into APC Rates | |
Partial Hospitalization | |
STVX-Packaged Codes | |
T-Packaged Codes | |
Codes That May Be Paid Through a Composite APC | |
Conditionally packaged laboratory tests | |
Blood and Blood Products | |
Significant Procedure, Not Discounted When Multiple | |
Significant Procedure, Multiple Reduction Applies | |
Brachytherapy Sources | |
Clinic or Emergency Department Visit | |
Ancillary Services | |
Non-Implantable Durable Medical Equipment |
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