Index

Index

A - B - C - D - E - F - G - H - I - J - L - M - N - O - P - Q - R - S - T - U - V - W - X - Z

Abatacept (Orencia)

Abortion services, family planning funding not used for

DFPS Abuse Hotline

requirements for

staff training on

Abuse and fraud policy

Accessories, durable medical equipment (DME) (home health)

resources and refunds

Acronym dictionary

Add date for client eligibility

Addendum to Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form

see Chemical dependency

appeals/adjustments

CPT coding manual

Department of Assistive and Rehabilitative Services (DARS), Blind Services

Claims Administrator Contract Management

Limited Program

Medical and UR Appeals

Office of Inspector General (OIG) 1 2

Third Party Resources Unit

Presumptive Eligibility Program

Provider Enrollment

Texas Medical Board registration department 1 2

appeals of incomplete claims

first time claims

HHSC written communication

Inquiry Control Unit

Special Medical Prior Authorization

Third Party Resources Unit

cervical cancer

communicable disease reporting

hyperlipidemia, screening for

Adoption agencies

Advance directives

Advanced practice nurse (APN)

benefits and limitations

Aerosol treatment

After-hours charges

ambulance night calls

Alatrofloxacin mesylate (Trovan)

chemical dependency 1 2

Alcohol (chemical dependency) 1 2

Aliens, undocumented, legalized, family planning services for

allergy injections

allergy services

Allergy immunotherapy

Allergy services

allergy injections

after-hours charges

benefits and limitations

claim form example 1 2

Medicare disposition

membership fees, subscription program

prior authorization process

transport prior authorization

nonemergency services

prior authorization

emergency out-of-state transport

retroactive eligibility

types, definitions

reimbursement 1 2

relation to time of death

air or specialized vehicle

multiple client

nursing facility

to or from state institutions

wait time billing

Ambulatory blood pressure monitoring

Ambulatory electroencephalogram (A/EEG)

benefits and limitations

Ambulatory surgical center

Ambulatory surgical center (ASC)

benefits and limitations

claim form example

claim form example (hospital-based)

National Drug Codes (NDC)

dental services

administered by surgeon

claim form example

for labor and delivery

for sterilization

gynecological examinations

multiple procedures

pain management

intrathecal morphine pumps

physician services

provided by the surgeon

medical direction

monitored anesthesia care

prior authorization requirements

reimbursement methodology

services incidental to surgery and/or anesthesia

Annual exams, family planning

Antibiotics and steroids

Antihemophilic factor

Antispasmodic drugs

see dolasetron mesylate (Anzemet)

administrative claim appeals

AIS appeals guide

allowed AIS appeals

advantages of electronic appeal submission

allowed electronic appeals

disallowed electronic appeals

electronic submission

family planning

disallowed appeals

complaints to HHSC fee-for-service

exception to the 120-day appeal deadline

exception to the 95-day filing deadline

fee-for-service

submitted incorrectly

telephone appeals

administrative claim

cost report settlement

fee-for-service DRG adjustments appeal

utilization review (UR)

continued stay denials

medical necessity 1 2

technical denials

Assays for the diagnosis of vaginitis

Audiological aervices

reimbursement, hearing aid and audiological services

Audiological services

School Health and Related Services (SHARS)

Auditory brainstem implant (ABI)

Augmentative communication device (ACD) system

noncovered items

prior authorization

Authorization for Use and Release of Health Information form

Authorization requirements

CT, CTA, MRI, and MRA

electrodiagnostic (EDX) testing

Automated Inquiry System

Bacillus Calmette-Guérin (BCG)

for treatment of bladder cancer

vaccine for intravesical

vaccine for transvesical

Bariatric surgery

prior authorization requirements

battery charger

Behavioral health services

outpatient, prior authorization for 1 2

Benefits and limitations

clinician-directed care coordination services (CCP)

occupational therapy

personal care services

private duty nursing

radiological and physiological laboratory and portable X-ray supplier

School Health and Related Services (SHARS)

Bilevel positive airway pressure system

with backup (such as BiPAP ST)

without backup (such as BiPAP S)

Billing clients

Birthing center

benefits and limitations

claim form example

national drug codes (NDC)

laboratory services

Medicaid Managed Care enrollment

reimbursement 1 2

Blepharoplasty procedures

Blind Children's Vocational Discovery and Development Program

benefits and limitations

claim form example

claims filing resources

claims information

reimbursement 1 2

STAR and STAR+PLUS Program enrollment

Blood counts 1 2

Blood pressure devices 1 2

cholesterol 1 2

hemoglobin type

Blood transfusions

Bone marrow aspiration

Botulinum toxin type A

Brachytherapy, radiation therapy

benefits and limitations

Breast cancer screening

prognostic breast cancer studies

Breast imaging studies

Breast reconstruction

bladder cancer, Bacillus Calmette-Guérin (BCG) for treatment

breast cancer screening

colorectal cancer screening

sigmoidoscopies

colorectal cancer testing

hereditary nonpolyposis colorectal cancer (HNPCC)

physician services

Prognostic breast and gynecological cancer studies

Canes, crutches, walkers

Cardiac blood pool imaging 1 2

benefits and limitations

Cardiopulmonary resuscitaiton (CPR)

Cardiorespiratory monitor

Case Management for Children and Pregnant Women (CPW) 1 2

assistance with claims concerns

assistance with program concerns

benefits and limitations

child abuse reporting

claim form example

referral process

reimbursement 1 2 3

STAR and STAR+PLUS Program enrollment

Case Management for Early Childhood Intervention

See Early Childhood Intervention (ECI)

Catheters, impantation

see Comprehensive Care Program

Centers for Medicare & Medicaid Services (CMS)

Certified nurse-midwife (CNM)

benefits and limitations

claims filing 1 2

claim form example

reimbursement 1 2

Certified registered nurse anesthetist (CRNA)

benefits and limitations

claims filing 1 2

claim form example

national drug codes (NDC)

claims management modifers

epidurals, blood patch

interpreting the R&S report

reimbursement 1 2

Certified respiratory care practitioner (CRCP)

benefits and limitations

claim form example

prior authorization

procedure codes

reimbursement 1 2

Cervical cancer screening

Chelating agents

deferoxamine mesylate (Desferal)

edetate calcium disodium

edetate disodium

Chemical dependency

behavioral health services

exceptions to limited status

psychiatric services

reimbursement 1 2

Chemical dependency treatment facility (CDTF)

benefits and limitations 1 2

claims filing 1 2

claim form example

outpatient counseling

reimbursement 1 2

procedure codes

Chest physiotherapy devices

Childhood Lead Poisoning Prevention Program

Children's hospitals

CHIP perinatal program

newborn transfer

client eligibility verification

program benefits

Chiropractic services

benefits and limitations

claim form example

reimbursement 1 2

Circumcisions 1 2

Cladribine (Leustatin)

Claims filing 1 2 3

appeal time limits

authorization for Medicaid HMO clients

banner message R&S example

birthing center

CHIP perinatal newborn transfer

claims filing instructions

diagnosis coding

procedure coding

type of service

Crossover Type 30 claim form (MRAN)

Crossover Type 31 and 50 claim form

deadline exceptions

appeal time limits

exceptions to the 95-day filing deadline

incomplete information

zero paid claims

electronic billing

provider check amounts

electronic claim acceptance

electronic claims

electronic rejections

newborn claim hints

electronic submission

filing a Medicare-adjusted claim

filing a Medicare-denied claim

hearing aid and audiological services

HHSC payment deadline

home health services

hospice clients

medical services

discharged hospice client

not related to terminal illness

attachments to claims

claim form requirements

clients with a designated or primary care provider

CMS-1500 claim form (blank)

CMS-1500 claim form (paper) billing

CMS-1500 electronic billing

CMS-1500 instruction table

Crossover Type 30 (MRAN)

Crossover Type 31 and 50

dental claim form

instruction table

dental filing instructions

claim form (paper) billing

electronic billing

Family Planning 2017 Claim Form (blank)

Family Planning 2017 Claim Form instruction table

group providers

multipage claim forms

newborn clients without Medicaid numbers

patient status codes

filing tips for outpatient claims

prior authorization numbers on claims

provider signature on claims

claim form (blank)

UB-04 CMS-1450 claim form (paper) billing

UB-04 CMS-1450 electronic billing

UB-04 CMS-1450 instruction table

UB-04 CMS-1450 occurrence codes

vision claim form

medical services

Medically Needy Program (MNP)

Medicare primary paper

Medicare/Medicaid deadlines

modifier requirements for TOS assignment

assistant surgery

interpretations

technical components

online radiology prior authorizations

other insurance filing

claims forward to other insurance carriers

prior authorization requests on Medicaid secondary claims

prior authorization requests through the web

processing procedures

payment error rate measurement (PERM)

delivery options

field explanation

radiological and physiological laboratory and portable X-ray supplier

Remittance and Status (R&S) Report

account receivables

backup withholding penalty information

claims in process

paid or denied claims (hospital)

paid or denied claims (physician)

refunds for Managed Care

refunds for Medicaid

sub-owner recoupments

void and stop pay

section explanation

status of claims

resubmission of TMHP EDI rejections

School Health and Related Services (SHARS)

appealing denied claims

billing units based on 15 minutes

billing units based on an hour

Claims filing instructions

ambulance transfers

birthing center

dental claim form

instruction table

home health services

Hysterectomy Acknowledgment Statement

Claims information

family planning

personal care services

private duty nursing

Texas Health Steps (THSteps)

Client billing 1 2

Client eligibility

CHIP perinatal program

deceased individuals

hospital services

Medicaid identification

restricted Medicaid coverage

selection of provider/pharmacy

Medicaid Buy-In Program

Medicaid eligibility verification

Medicaid for breast and cervical cancer

Medicaid Identification

Medicare Part B Crossovers

Medicare/Medicaid

clients without QMB, MQMB status

contract with outside parties

personal care services

telephone appeals

THSteps medical checkup

Women's Health Program (WHP)

Clinical Laboratory Improvement Amendments (CLIA)

comprehensive health center (CHC)

Clinical nurse specialist

benefits and limitations

claim form example

reimbursement 1 2

Clinical pathology consultations

Clinical records

Clinician-directed care coordination services (CCP)

claim form (blank)

electronic billing

instruction table 1 2

see Clinical nurse specialist

Cochlear implant 1 2

auditory brainstem implant (ABI)

aural rehabilitation

authorization requirements

nonrechargeable batteries

post implant speech therapy 1 2

sound processor replacement

diagnosis coding

independent laboratories, pathologists, radiologists

neonatal intensive care codes

place of service (POS) 1 2

precoding paper claims

procedure coding

type of service (TOS)

Colony stimulating factors

Colorectal cancer screening

genetic testing

sigmoidoscopies

Commodity supplemental food program

Communicable disease reporting 1 2

Community health centers (CHC)

Complaints to DSHS - BHO Services

Complete blood count (CBC)

Comprehensive Care Program (CCP)

Comprehensive health center (CHC)

Clinical Laboratory Improvement Amendments (CLIA)

physician services

Comprehensive outpatient rehabilitation facility (CORF) 1 2

THSteps-CCP claims filing

claim form example

Computed tomography angiography (CTA)

benefits and limitations

Computed tomography imaging (CT)

benefits and limitations

Computer-aided detection (CAD)

Confidential information

procedure codes

Continuous glucose monitoring (CGM)

prior authorization requirements

Continuous positive airway pressure (CPAP)

devices, family planning

elective sterilization services

hysteroscopic sterilization services

implantable capsules

Contraction stress test

Contrast materials

benefits and limitations

see Comprehensive Outpatient Rehabilitation Facility (CORF)

Corneal topography

Corrective shoes

Counseling services

School Health and Related Services (SHARS)

see Case Management for Children and Pregnant Women

Cranial molding orthotics

Craniostenosis (protective) helmets

Crime Victims' Compensation Program

Medically Needy Program

see Vitamin B12 (Cyanocobalamin)

Cytogenetics testing for leukemia and lymphoma

Cytopathology studies

other than gynecological

Darbepoetin alfa

Date of service (DOS)

see liposomal encapsulated daunorubicin (DaunoXome)

Deferoxamine mesylate (Desferal)

Denileukin diftitox (Ontak)

instruction table

adjunctive general services

benefits and limitations

claims and appeals

claim form (paper) billing

client eligibility

diagnostic services

doctor of dentistry practicing as a limited physician

electronic claim billing

emergency services

clients over 21

First Dental Home

general information

handicapping labiolingual deviation (HLD)

HLD score sheet 1 2

hospitalization

ICF-MR dental services

ICF-MR Dental Services

implant services

informed consent

mandatory prior authorization

Medicaid Managed Care enrollment

medical necessity

oral/maxillofacial surgery

orthodontic procedure codes

orthodontic services

comprehensive treatment

mandatory prior authorization

special orthodontic appliances

transfer of services

treatment plans

periodontal services

preventive services

prosthodontics, removable

provider enrollment

reimbursement 1 2

reporting child abuse or neglect

root canal therapy

services (THSteps)

space maintenance (passive appliance)

supernumerary tooth identification

tests and examinations

therapeutic services

third-party resources

THSteps dental services 1 2

TMHP contact information

tooth identification (TID) and surface identification (SID)

treatment plans

utilization review

Dentist (Doctor of Dentistry)

Department of Assistive and Rehabilitative Services (DARS), Blind Services

contact information

Diabetic supplies/equipment

Diagnosis codes

Diagnosis coding

Diagnosis requirements

radiological and physiological laboratory and portable X-ray supplier

benefits and limitations

Diagnostic tests

claim form example

Disallowed appeals, family planning

see Durable medical equipment

Doctor of dentistry

claim form example

limited physician

claims information 1 2

diagnosis codes

mandatory prior authorization

Medicaid Managed Care enrollment

Donor human milk

Doppler studies

Drug abuse, psychiatric services for

chemotherapeutic

Durable medical equipment (DME)

accessories (home health)

accessories (THSteps-CCP)

adjustments (THSteps-CCP)

benefits and limitations (THSteps-CCP)

blood pressure devices 1 2

claim form example (THSteps-CCP)

cochlear implants

continuous passive motion device

incontinence supplies (THSteps-CCP)

mobility aids coding (THSteps-CCP)

modifications (home health)

modifications (THSteps-CCP)

physician signature (THSteps-CCP)

prior authorization

reimbursement (THSteps-CCP)

rental (THSteps-CCP)

repairs (THSteps-CCP) 1 2

supplier (THSteps-CCP)

supplier policies (THSteps-CCP)

Durable medical equipment (DME) Certification and Receipt Form

Early Childhood Intervention

Early Childhood Intervention (ECI) 1 2

benefits and limitations 1 2

case management

claims filing 1 2 3

claim form example (THSteps-CCP only)

enrollment 1 2 3

reimbursement 1 2

STAR and STAR+PLUS Program enrollment

statutory requirements

Echoencephalography

see Early Childhood Intervention (ECI)

Edetate calcium disodium

Edetate disodium

Education, family planning

see electrodiagnostic (EDX) testing

see Idursulfase (Elaprase)

Elective abortions

required statements for claims

Elective sterilization

Electrical percussor

Electrocardiogram (EKG)