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2012 Texas Medicaid Provider Procedures Manual

Inpatient and Outpatient Hospital Services Handbook : 5. Ambulatory Surgical Center and Hospital Ambulatory Surgical Center : 5.2 Services/Benefits, Limitations, and Prior Authorization : 5.2.4 Planned Admission for Day Surgery

5.2.4
Inpatients may occasionally require a surgery that has been designated as an outpatient procedure. The physician must document the need for this surgery as an inpatient procedure before the procedure is performed. These claims are subject to retrospective review.
5.2.5 Cochlear Implants
A cochlear implant is a benefit of Texas Medicaid when medically indicated. ASC and HASC providers may be reimbursed for the implantation procedure using procedure code 69930, and for the cochlear implant devices using procedure code L8614.
Refer to:
Subsection 8.2.24, “Cochlear Implants,” in Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (Vol. 2, Provider Handbooks).
5.2.6 Colorectal Cancer Screening
Procedure codes G0104 and G0105 are benefits of Texas Medicaid in the ASC or HASC setting.
Procedure code G0104 is limited to diagnosis codes V1090, V1272, V7650, V7651, V7652, or V700. Procedure code G0105 is limited to the following diagnosis codes:
Authorization is not required for colorectal cancer screening.
Refer to:
Subsection 8.2.16.1, “Colorectal Cancer Screening,” in Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (Vol. 2, Provider Handbooks).

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