HCPCS G2143 Code. Fs odi 9-15mo > 22

HCPCS Code: G2143
Long Description: Functional status measured by the oswestry disability index (odi version 2.1a) at one year (9 to 15 months) postoperatively was greater than 22 and functional status measured by the odi version 2.1a within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated an improvement of less than 30 points
Short Description: Fs odi 9-15mo > 22

Original information is taken from G2143 page

Pricing Indicator Code 1: 00 – Service not separately priced by part B (e.g., services not covered, bundled, used by part a only, etc.)
Multiple Pricing Indicator 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')

Coverage: C – Carrier judgment

Berenson-Eggers Type of Service (BETOS): Z2 – Undefined codes
Type Of Service 1: 1 – Medical care

Anesthesia Base Unit Quantity: 0
Code Added Date: 20200101
Code Effective Date: 20220101
Action Code: N – No maintenance for this code