[613] | 1 | ECXAPRO3 ;ALB/JAP - PRO Extract Audit Report (cont) ; APR 25,2006
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| 2 | ;;3.0;DSS EXTRACTS;**21,31,76,94**;Dec 22, 1997
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| 3 | ;
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| 4 | TEXT ;description of line numbers as in des^rmprn62 plus summary headers
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| 5 | ;;100;WHEELCHAIRS AND ACCESSORIES
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| 6 | ;;100 A;MOTORIZED
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| 7 | ;;100 A1;SCOOTERS
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| 8 | ;;100 B;MANUAL CUSTOM
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| 9 | ;;100 C;MANUAL A/O
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| 10 | ;;100 D;ACCESSORIES
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| 11 | ;;100 E;CUSHION FOAM
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| 12 | ;;100 F;CUSHION SPEC
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| 13 | ;;100 G;CARRIERS
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| 14 | ;;100 H;NSC VAN MODS
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| 15 | ;;100 I;SCOOTER ACCESSORIES
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| 16 | ;;200;ARTIFICIAL LEGS
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| 17 | ;;200 A;LEG IPOP
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| 18 | ;;200 B;LEG TEM
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| 19 | ;;200 C;LEG PART FOOT
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| 20 | ;;200 E;LEG SYMES
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| 21 | ;;200 F;LEG B/K
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| 22 | ;;200 G;LEG A/O
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| 23 | ;;200 H;LEG A/K
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| 24 | ;;200 I;LEG COMPONENT
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| 25 | ;;300;ARTIFICIAL ARMS AND TERMINAL DEVICES
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| 26 | ;;300 A;ARM B/E
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| 27 | ;;300 B;ARM, A/E
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| 28 | ;;300 C;COSMETIC GLOVES
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| 29 | ;;300 D;ARM, A/O
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| 30 | ;;300 E;TERMINAL DEVICES
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| 31 | ;;300 F;EXT. POWERED,ARM
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| 32 | ;;400;BRACES AND ORTHOTICS
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| 33 | ;;400 A;BRACE ANKLE
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| 34 | ;;400 B;BRACE LEG AK
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| 35 | ;;400 C;BRACE, SPINAL
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| 36 | ;;400 D;BRACE AL/OTH
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| 37 | ;;400 E;ELAS HOSE, EA
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| 38 | ;;400 F;BRACES, KNEE
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| 39 | ;;400 G;CORSET/BELT
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| 40 | ;;400 H;ORTHOSIS WHO
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| 41 | ;;400 X;ORTHOTICS UNKNOWN
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| 42 | ;;500;SHOES/ORTHOTICS
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| 43 | ;;500 A;ARCH SUPT, EA
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| 44 | ;;500 B;SHOE INLAY, EA
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| 45 | ;;500 C;SHOE MOLDED, EA
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| 46 | ;;500 D;SHOE ORTH OTH
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| 47 | ;;500 E;INSERTS, SHOE
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| 48 | ;;500 F;SHOES A/O, EA
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| 49 | ;;600;NEUROSENSORY AIDS
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| 50 | ;;600 1;EYEGLASSES PR
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| 51 | ;;600 A;SP OVER 2,500
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| 52 | ;;600 B;HEARING AIDS
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| 53 | ;;600 C;AID FOR BLIND
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| 54 | ;;600 D;CONT LENS, EA.
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| 55 | ;;600 E;EAR INSERT
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| 56 | ;;600 F;ASST LISTENING DEVICES
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| 57 | ;;600 G;SPEECH DEVICES
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| 58 | ;;700;RESTORATIONS
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| 59 | ;;700 A;EYE
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| 60 | ;;700 B;FACIAL
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| 61 | ;;700 C;BODY, OTHER
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| 62 | ;;800;OXYGEN AND RESPIRATORY
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| 63 | ;;800 A;OXYGEN EQP
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| 64 | ;;800 B;OXYGEN CONCEN
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| 65 | ;;800 C;OXYGEN GAS
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| 66 | ;;800 D;OXYGEN, SUPPLIES
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| 67 | ;;800 E;OXYGEN LIQUID
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| 68 | ;;800 F;VENTILATOR, A/O
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| 69 | ;;800 G;RESPIRATORY EQUIPMENT
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| 70 | ;;800 H;RESPIRATORY SUPPLIES
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| 71 | ;;900;MEDICAL EQUIPMENT
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| 72 | ;;900 A;WALKING AIDS
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| 73 | ;;900 B;INVALID LIFT
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| 74 | ;;900 C;BED HOSP STD
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| 75 | ;;900 D;BED HOSP SPEC
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| 76 | ;;900 E;MATTRESS STAN
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| 77 | ;;900 F;MATTRESS SPEC
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| 78 | ;;900 G;BED, ACCESSORIES
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| 79 | ;;900 H;ENVIRON CONTR
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| 80 | ;;900 I;SPEC HOME EQP (SAFETY)
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| 81 | ;;900 J;TENS UNIT
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| 82 | ;;900 K;MED EQP AL/OTH
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| 83 | ;;900 L;EQP RENTAL
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| 84 | ;;900 M;COMPUTER EQUIPMENT
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| 85 | ;;900 N;TELEHEALTH
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| 86 | ;;910;ALL OTHER SUPPLIES AND EQUIPMENT
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| 87 | ;;910 A;MED SUP AL/OTH
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| 88 | ;;920;HOME DIALYSIS PROGRAM
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| 89 | ;;920 A;HOME DIAL EQP
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| 90 | ;;920 B;HOME DIAL SUP
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| 91 | ;;930;ADAPTIVE EQUIPMENT
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| 92 | ;;930 A;MOD VANS
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| 93 | ;;930 B;ADAPT EQP AL/OTH
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| 94 | ;;940;HISA
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| 95 | ;;940 A;HISA SC
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| 96 | ;;940 B;HISA NSC
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| 97 | ;;960;SURGICAL IMPLANTS
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| 98 | ;;960 A;HEAD & NECK
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| 99 | ;;960 A1;H&N INTRAOCULAR LENS
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| 100 | ;;960 A2;H&N HEAD
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| 101 | ;;960 A3;H&N NECK
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| 102 | ;;960 A4;H&N EYES A/O
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| 103 | ;;960 B;ABDOMEN
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| 104 | ;;960 B1;ABDOMEN STENT
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| 105 | ;;960 B2;ABDOMEN MESH
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| 106 | ;;960 B3;ABDOMEN CATHETER
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| 107 | ;;960 C;UPPER EXTREMITY
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| 108 | ;;960 C1;UE ARM
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| 109 | ;;960 C2;UE SHOULDER
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| 110 | ;;960 C3;UE HAND
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| 111 | ;;960 D;LOWER EXTREMITY
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| 112 | ;;960 D1;LE HIP
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| 113 | ;;960 D2;LE KNEE
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| 114 | ;;960 D3;LE FOOT
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| 115 | ;;960 E;THORACIC
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| 116 | ;;960 E1;THOR PACEMAKER/LEADS
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| 117 | ;;960 E2;THOR ICD/LEADS
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| 118 | ;;960 E3;THOR STENTS
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| 119 | ;;960 E4;THOR VALVE
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| 120 | ;;960 F;DENTAL IMPLANT
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| 121 | ;;960 G;ALL SCRWS,PLTS, ANCRS, ETC.
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| 122 | ;;960 X;SI UNKNOWNS (ALL)
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| 123 | ;;999;MISC
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| 124 | ;;999 A;AL/OTH ITEMS
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| 125 | ;;999 X;HCPCS NOT GRP
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| 126 | ;;999 Z;NO HCPCS
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| 127 | ;;R07;HEARING AID, LOCAL REPAIRS
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| 128 | ;;R10;WHEELCHAIRS AND ACCESSORIES
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| 129 | ;;R10 A;WHEELCHAIR
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| 130 | ;;R10 B;CARRIERS
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| 131 | ;;R10 C;NSC VAN MODS
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| 132 | ;;R10 ;WHEELCHAIR
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| 133 | ;;R20;ARTIFICIAL LEGS
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| 134 | ;;R20 A;LEG A/K
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| 135 | ;;R20 B;LEG B/K, PTB
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| 136 | ;;R20 C;LEG B/K, STD
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| 137 | ;;R20 D;LEG ALL OTHER
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| 138 | ;;R30;ARTIFICIAL ARMS AND TERMINAL DEVICES
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| 139 | ;;R30 ;ART ARM,TOTAL
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| 140 | ;;R40;BRACES AND ORTHOTICS
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| 141 | ;;R40 ;BRACE TOTAL
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| 142 | ;;R50;SHOES/ORTHOTICS
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| 143 | ;;R50 A;ORTH SHOE ALL
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| 144 | ;;R50 B;SHOE MOD
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| 145 | ;;R50 C;A/O ITEM SERV
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| 146 | ;;R60;NEUROSENSORY AIDS
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| 147 | ;;R60 A;AID FOR BLIND
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| 148 | ;;R60 B;EYEGLASS RPR
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| 149 | ;;R60 C;HEARING AID
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| 150 | ;;R60 D;ASST LISTENING DEVICE
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| 151 | ;;R60 E;SPEECH DEVICES
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| 152 | ;;R70;HOME DIALYSIS EQUIPMENT
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| 153 | ;;R70 ;HOME DIAL EQU
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| 154 | ;;R80;MEDICAL EQUIPMENT
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| 155 | ;;R80 A;INVALID LIFTS
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| 156 | ;;R80 B;REPAIR TO ECU
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| 157 | ;;R80 C;MED EQUIP A/O
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| 158 | ;;R80 D;HME DELIVERY/PICKUP
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| 159 | ;;R80 E;TELEHEALTH
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| 160 | ;;R90;ALL OTHER
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| 161 | ;;R90 ;ALL OTHER
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| 162 | ;;R90 A;SHIPPING
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| 163 | ;;R90 B;TRAINING
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| 164 | ;;R91;O2 & RESPIRATORY
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| 165 | ;;R91 A;CONCENTRATOR
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| 166 | ;;R91 B;VENTILATOR
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| 167 | ;;R91 C;EQUIPMENT A/O
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| 168 | ;;R91 D;SERVICE VISIT
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| 169 | ;;R91 E;COMPRESSED O2
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| 170 | ;;R91 F;LIQUID O2
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| 171 | ;;R91 G;LIQUID DEL SYS
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| 172 | ;;R91 H;RESPIRATORY EQUIP
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| 173 | ;;R99 A;SHIPPING
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| 174 | ;;R99 X;HCPCS NOT GRP
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| 175 | ;;R99 Z;NO HCPCS
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| 176 | ;;QUIT
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