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2012 Texas Medicaid Provider Procedures Manual

Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook : 2. Texas Medicaid (Title XIX) Home Health Services : 2.2 Services, Benefits, Limitations and Prior Authorization : 2.2.12 Incontinence Supplies : Documentation Requirements
To request prior authorization for incontinence supplies and equipment, the following documentation must be provided:
Diagnostic information pertaining to the underlying diagnosis or condition, the diagnosis causing incontinence, and any other medical diagnoses or conditions, including the client's overall health status
Additional information may be requested to clarify or complete a request for the supplies.

Texas Medicaid & Healthcare Partnership
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