Recode Indicators

Usage

recode_mod(x, which = "label")

recode_glob(x, which = "label")

recode_team(x)

recode_bilat(x, which = "label")

recode_mult(x, which = "label")

recode_cosurg(x)

recode_asst(x)

recode_diag(x)

recode_pctc(x, which = "label")

recode_status(x, which = "label")

Arguments

x: <chr> vector of indicators
which: <chr> which information to return; "label", "desc" or "rule" (see individual functions for available options)

Value

<chr> vector of descriptions

Multiple Surgery

100% of MPFS amount is allowed for highest valued surgical procedure and 50% for additional surgical procedures (with a multiple surgery indicator of "2") performed same day. Modifier 51 will be appended to identify reduced services.

Assistant Surgery

Modifiers:

80: Assistance by Another Physician
81: Minimal Assistance by a Another Physician
82: Assistance by Another Physician when Qualified Resident Surgeon Unavailable
AS: Non-Physician Assistant at Surgery

Physician Assistant-at-surgery Services:

Allowed at 85% of MPFS and then 16% of that amount is allowed for Assistant-at-surgery.

Diagnostic Imaging

Identifies the applicable Diagnostic Service family for HCPCS codes with a Multiple Procedure indicator of 4.

Examples

# PC/TC Modifiers
recode_mod(c("26", "TC", "53"))
#> [1] "Professional Component" "Technical Component"    "Discontinued Procedure"

# Global Days
recode_glob(c(0, 1, 9, "M", "Y", "Z"))
#> [1] "1 Day Post-Op"  "10 Day Post-Op" "90 Day Post-Op" "Maternity"     
#> [5] "Carrier"        "Bundled"       

# Team Surgery (Mod 66)
recode_team(0:2)
#> [1] "Restricted"        "Medical Necessity" "Permitted"        

# Bilateral Surgery (Mod 50)
recode_bilat(0:3)
#> [1] "No Adjustment" "Adjustment"    "No Adjustment" "No Adjustment"

# Multiple Procedure (Mod 51)
recode_mult(0:7)
#> [1] "No Adjustment"            "Standard Adjustment"     
#> [3] "Standard Adjustment"      "Multiple Endoscopy"      
#> [5] "Diagnostic Imaging"       "Therapy Reduction"       
#> [7] "Cardiovascular Reduction" "Ophthalmology Reduction" 

# Co-Surgeon (Mod 62)
recode_cosurg(0:2)
#> [1] "Restricted"        "Medical Necessity" "Permitted"        

# Assistant Surgery (Mods 80-82, AS)
recode_asst(0:2)
#> [1] "Medical Necessity" "Restricted"        "Permitted"        

# Diagnostic Imaging Reduction (mult == 4)
recode_mult(4)
#> [1] "Diagnostic Imaging"
recode_diag(1)
#> [1] "PC/TC Diagnostic Imaging Reduction"
recode_pctc(1)
#> [1] "Diagnostic Tests for Radiology Services"

# PC/TC Indicator
recode_pctc(0:8, "rule")
#> [1] "26/TC Not Permitted" "26/TC Permitted"     "TC Not Permitted"   
#> [4] "26/TC Not Permitted" "26/TC Not Permitted" "26/TC Not Permitted"
#> [7] "TC Not Permitted"    "26/TC Not Permitted" "TC Not Permitted"   

# Status Codes
recode_status(LETTERS[c(1:10, 13:14, 16, 18, 20, 24)])
#>  [1] "Active"                 "Payment Bundle"         "Carrier Priced"        
#>  [4] "Deleted Codes"          "Regulatory Exclusion"   "Deleted/Discontinued"  
#>  [7] "Not Valid for Medicare" "Deleted Modifier"       "Not Valid for Medicare"
#> [10] "Anesthesia Service"     "Measurement Code"       "Restricted Coverage"   
#> [13] "Non-Covered Service"    "Bundled/Excluded Code"  "Injections"            
#> [16] "Statutory Exclusion"