|
The place of service or diagnosis may be
considered when determining the appropriate
TOS. The descriptors for each of the TOS
codes listed in the following table are:
|
|
TOS Code |
TOS Description |
|
0
|
Whole blood
|
|
1
|
Medical care
|
|
2
|
Surgery
|
|
3
|
Consultation
|
|
4
|
Diagnostic radiology
|
|
5
|
Diagnostic laboratory
|
|
6
|
Therapeutic radiology
|
|
7
|
Anesthesia
|
|
8
|
Assistant at surgery
|
|
9
|
Other medical items or services
|
|
A
|
Use DME
|
|
B
|
High risk screening mammography
|
|
C
|
Low risk screening mammography
|
|
D
|
Ambulance
|
|
E
|
Enteral/Parenteral nutrients/supplies
|
|
F
|
Ambulatory Surgical Center (facility usage
for surgical services)
|
|
G
|
Immunosuppressive drugs
|
|
H
|
Hospice
|
|
J
|
Diabetic shoes
|
|
K
|
Hearing items and services
|
|
L
|
ESRD supplies
|
|
M
|
Monthly capitation payment for dialysis
|
|
N
|
Kidney donor
|
|
P
|
Lump sum purchase of DME, prosthetics,
orthotics
|
|
Q
|
Vision items or services
|
|
R
|
Rental of DME
|
|
S
|
Surgical dressings or other medical supplies
|
|
T
|
Outpatient mental health treatment
limitation
|
|
U
|
Occupational therapy
|
|
V
|
Pneumococcal/Flu vaccine
|
|
W
|
Physical therapy
|
|
NOTE:
For injection codes with more than one possible TOS designation,
use the following guidelines when assigning the TOS:
When the choice is L or 1,
•
Use TOS L when the drug is used related to ESRD; or
•
Use TOS 1 when the drug is not related to ESRD and is
administered in the office.
When the choice is G or 1:
•
Use TOS G when the drug is an immunosuppressive drug; or
•
Use TOS 1 when the drug is used for other than immunosuppression.
When the choice is P or 1,
•
Use TOS P if the drug is administered through durable medical
equipment (DME); or
•
Use TOS 1 if the drug is administered in the office.
For a complete guide to the TOS indicators visit
IOM 100-04 Chapter 26, section 10.7 –
Type of Service (TOS)
|
|