CSHCN 2009 > Physician > Benefits, Limitations, and Authorization Requirements

   
 

29.2.35 Surgery

Authorization of cosurgeon and assistant surgeon services is not required; however, all other authorization requirements associated with the surgical procedure must be met.

Specific surgical procedures require prior authorization. If a prior authorization is not obtained for the procedure, the facility's services, the surgeon's services and the assistant surgeon's services are denied; however, anesthesia services may be paid.

Prior authorization must be obtained for procedures that are completed by a specialty team or in a specialty center. Criteria unique to specific surgical procedures must be satisfied as indicated in the appropriate sections below.


Texas Medicaid & Healthcare Partnership
CPT only copyright 2008 American Medical Association. All rights reserved.
PreviousNextIndex