| HCPCS Code: |
G9313 |
| Long Description: |
Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason (eg, cystic fibrosis, immotile cilia disorders, ciliary dyskinesia, immune deficiency, prior history of sinus surgery within the past 12 months, and anatomic abnormalities, such as deviated nasal septum, resistant organisms, allergy to medication, recurrent sinusitis, chronic sinusitis, or other reasons) |
| Short Description: |
Docrsn not first line amox |
| Pricing Indicator 1: |
00 (Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)) |
| Multiple Pricing Code: |
9 (Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is 99)) |
| Statute Number: |
|
| Coverage Code: |
C (Carrier judgment) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
M5B (Specialist - psychiatry) |
| Type of Service Code 1: |
1 (Medical care) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-01-2014 |
| Action Effective Date: |
01-01-2014 |
| Action Code: |
A (Add procedure or modifier code) |
