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2012 Texas Medicaid Provider Procedures Manual

Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook : 8. Physician : 8.2 Services, Benefits, Limitations, and Prior Authorization : 8.2.43 Mastectomy and Breast Reconstruction : Limitations for Mastectomy and Breast Reconstruction
In the following table, the procedure codes in Column B will be denied when billed with the same date of service by the same provider as the corresponding procedure codes in Column A:
The following services are not benefits of Texas Medicaid:

Texas Medicaid & Healthcare Partnership
CPT only copyright 2011 American Medical Association. All rights reserved.