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:
Type of Service Indicators
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 Used 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
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