TMPPM 2008 > Texas Medicaid Services > Independent Laboratory > Benefits and Limitations

   
 

26.4.11 Transfusion Medicine

Procedure code 5-86890 is denied when billed by any provider for the same client for dates of service in excess of two times within four days. The use of modifier 76 does not prevent claim denials. Documentation may be submitted on appeal that supports the medical necessity and appropriateness of more than two predeposited autologous donations in four days.


Texas Medicaid & Healthcare Partnership
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