Crystal's MCW Coder Hub🏷️ Status Indicators Quick Reference
🎯 Purpose
Quick lookup for OPPS (Outpatient Prospective Payment System) status indicators used on facility claims.
🧩 Common Status Indicators
| SI | Meaning |
|---|---|
| S | Significant procedure, not discounted |
| T | Significant procedure, multiple-procedure reduction applies |
| X | Ancillary service |
| Q1 | STV-packaged: conditionally packaged service |
| Q2 | T-packaged: conditionally packaged procedure |
| Q3 | Codes that may be paid separately or packaged depending on circumstances |
| N | Packaged service (always packaged, no separate payment) |
| E1 | Non-covered by Medicare |
| J1 | Comprehensive APC (single payment for all services on claim) |
| J2 | Comprehensive observation services |
| K | Non-pass-through drugs and biologicals |
| L | Influenza/pneumococcal vaccines |
| M | Clinical laboratory tests |
| R | Blood and blood products |
🧠 Notes
- Status indicators determine how a service is paid under OPPS.
- Q‑status indicators require conditional logic based on other services on the claim.
- N‑status items are always packaged — never separately reimbursed.
- J1/J2 indicate comprehensive APCs, meaning one payment covers nearly everything on the claim.