- Short DescriptionNtiol category 5
- HCPCS Coverage CodeD = Special coverage instructions apply
- HCPCS Action CodeN = No maintenance for this code
- HCPCS Action Effective DateOct 01, 2003
- HCPCS Code Added DateJul 01, 1999
- HCPCS Pricing Indicator Code57 = Other carrier priced
- HCPCS Multiple Pricing Indicator CodeA = Not applicable as HCPCS priced under one methodology
- HCPCS Cross Reference Code
- HCPCS Type Of Service CodeF
- HCPCS Anesthesia Base Unit Quantity