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2012 Texas Medicaid Provider Procedures Manual

Inpatient and Outpatient Hospital Services Handbook : 4. Outpatient Hospital (Medical/Surgical Acute Care Outpatient Facility) : 4.2 Services, Benefits, Limitations, and Prior Authorization : 4.2.19 Respiratory Services : 4.2.19.2 Pentamidine Aerosol

4.2.19.2
Pentamidine Aerosol
Aerosol pentamidine treatments are reimbursed using procedure code 94642. The provider may also be reimbursed for the medication using procedure code J2545.
Payment for aerosol pentamadine treatments is limited to the following diagnosis codes:
Aerosol pentamidine treatments are limited to one treatment every 28 days.
Oral trimethoprim-sulfamethoxazole is available from pharmacies for self administration at home. The use of oral trimethoprim-sulfamethoxazole is not a payable benefit of the insured portion of Texas Medicaid.

Texas Medicaid & Healthcare Partnership
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