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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 : 2.2.19 Respiratory Equipment and Supplies : Electrical Percussor
Electrical Percussor
The purchase of an electrical percussor is limited to one every 5 years and a rental is limited to once per month for a maximum of four months per lifetime. Providers must use procedure code E0480 when billing for the percussor. Prior Authorization
The electrical percussor device requires prior authorization and may be reimbursed for rental or purchase depending on the physician’s predicted length of treatment. In addition to the completed Home Health Services (Title XIX) Durable Medical Equipment (DME)/Medical Supplies Physician Order Form, a description of all previous courses of therapy and why they did not adequately assist the client in airway mucus clearance is required to obtain prior authorization for an electrical percussor.

Texas Medicaid & Healthcare Partnership
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