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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 : 5.2.12 Neurostimulators

5.2.12
Neurostimulators are a benefit of Texas Medicaid when medically necessary. All procedures require prior authorization.
Refer to:
Subsection 8.2.44, “Neurostimulators,” in Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (Vol. 2, Provider Handbooks).
The following procedure codes are payable to ASCs and HASCs:
L8686 with modifier TG
Neuorstimulator devices may be reimbursed separately from the global fee.

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