HCPCS code P9604 — One-way allow prorated trip.
Status: Active.
Effective Jan 1, 1992.
Source: CMS HCPCS Level II.
P9604
ActiveOne-way allow prorated trip
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge
Category:
Pathology & Lab
Section:
P-codes: Pathology and Laboratory
Effective:
Jan 1, 1992
Code type:
alphanumeric
OPPS Status:
A
— Paid under a separate fee schedule (not OPPS)
MUE — Medically Unlikely Edits
Maximum units of P9604 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.
| Service Type | Max Units / Day |
|---|---|
| Outpatient Hospital | 2 |
| Practitioner Services | 2 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NCCI Edits — Reverse Direction
P9604 cannot be billed together with the following column 1 codes without appropriate documentation.
| Column 1 Code | Modifier |
|---|---|
| P9603 | Modifier may bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)