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Type of Service Indicators

The document provides descriptions for Type of Service (TOS) codes, which indicate the place or diagnosis for a medical service. There are 26 TOS codes listed from 0 to W that describe services like whole blood, medical care, surgery, diagnostic tests, durable medical equipment, vaccines, and various therapies. Notes provide guidelines for assigning the correct TOS code when there are multiple options, such as choosing between codes L or 1, G or 1, and P or 1 based on whether the service relates to end stage renal disease, is an immunosuppressive drug, or uses durable medical equipment. A complete guide to TOS indicators can be found in IOM 100-04 Chapter 26, section 10.7.

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93 views2 pages

Type of Service Indicators

The document provides descriptions for Type of Service (TOS) codes, which indicate the place or diagnosis for a medical service. There are 26 TOS codes listed from 0 to W that describe services like whole blood, medical care, surgery, diagnostic tests, durable medical equipment, vaccines, and various therapies. Notes provide guidelines for assigning the correct TOS code when there are multiple options, such as choosing between codes L or 1, G or 1, and P or 1 based on whether the service relates to end stage renal disease, is an immunosuppressive drug, or uses durable medical equipment. A complete guide to TOS indicators can be found in IOM 100-04 Chapter 26, section 10.7.

Uploaded by

Naman Raval
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Type of Service (TOS) Indicators

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).

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