TMPPM 2007 >24.5.14.8 Wound Care Procedures and Limitations


Procedure Code	Maximum Limitation
9-A4213	As needed
9-A4217	As needed
9-A4244	1 per month
9-A4245	Per box as needed
9-A4246	1 per month
9-A4247	1 per month
9-A4450	20 per month
9-A4452	20 per month
9-A4455	4 per month
9-A4461	As needed
9-A4930	As needed
9-A6000	15 per month
9-A6010	As needed
9-A6011	As needed
9-A6021	As needed
9-A6022	As needed
9-A6023	As needed
9-A6024	As needed
9-A6025	As needed
9-A6154	As needed
9-A6196	As needed
9-A6197	As needed
9-A6198	As needed
9-A6199	As needed
9-A6200	As needed
9-A6201	As needed
9-A6202	As needed
9-A6203	As needed
9-A6204	As needed
9-A6205	As needed
9-A6206	As needed
9-A6207	As needed
9-A6208	As needed
9-A6209	As needed
9-A6210	As needed
9-A6211	As needed
9-A6212	As needed
9-A6213	As needed
9-A6214	As needed
9-A6215	As needed
9-A6216	As needed
9-A6217	As needed
9-A6218	As needed
9-A6219	As needed
9-A6220	As needed
9-A6221	As needed
9-A6222	As needed
9-A6223	As needed
9-A6224	As needed
9-A6228	As needed
9-A6229	As needed
9-A6230	As needed
9-A6231	As needed
9-A6232	As needed
9-A6233	As needed
9-A6234	As needed
9-A6235	As needed
9-A6236	As needed
9-A6237	As needed
9-A6238	As needed
9-A6239	As needed
9-A6240	As needed
9-A6241	As needed
9-A6242	As needed
9-A6243	As needed
9-A6244	As needed
9-A6245	As needed
9-A6246	As needed
9-A6247	As needed
9-A6248	As needed
9-A6251	As needed
9-A6252	As needed
9-A6253	As needed
9-A6254	As needed
9-A6255	As needed
9-A6256	As needed
9-A6257	As needed
9-A6258	As needed
9-A6259	As needed
9-A6260	As needed
9-A6261	As needed
9-A6262	As needed
9-A6266	As needed
9-A6402	As needed
9-A6403	As needed
9-A6404	As needed
9-A6407	As needed
9-A6410	As needed
9-A6411	As needed
9-A6412	As needed
9-A6441	As needed
9-A6442	As needed
9-A6443	As needed
9-A6444	As needed
9-A6445	As needed
9-A6446	As needed
9-A6447	As needed
9-A6448	As needed
9-A6449	As needed
9-A6450	As needed
9-A6451	As needed
9-A6452	As needed
9-A6453	As needed
9-A6454	As needed
9-A6455	As needed
9-A6456	As needed
9-A4657	As needed
9-A6550	15 per month
9-T1999	As needed
L-E0231	1 per month
L-E0232	1 per month
L-E1399	1 per month (for use with Pulsatile Jet Irrigation Wound Care System)
L-E2402	1 per month