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2012 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : 2. Medicaid Children’s Services Comprehensive Care Program (CCP) : 2.4 Durable Medical Equipment (DME) Supplier (CCP) : 2.4.3 Prior Authorization and Documentation Requirements : Equipment Repairs
Equipment Repairs
Repairs require replacement of components that are no longer functional. Repairs to client-owned equipment may be considered for reimbursement with prior authorization through CCP.
Technician fees are considered part of the cost of the repair. Providers must use procedure code K0739.
Repairs for non-warranty DME may be billed using procedure code K0739. Non-warranty DME repairs will require prior authorization. Providers are responsible for maintaining documentation in the client’s medical record that specifies the repairs and supporting medical necessity.
Rentals may be considered for reimbursement during the repair period of the client’s owned equipment.
Routine maintenance of rental equipment is the provider’s responsibility.

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