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2012 Texas Medicaid Provider Procedures Manual

Radiology and Laboratory Services Handbook : 2. Independent Laboratory : 2.2 Services, Benefits, Limitations, and Prior Authorization : 2.2.9 Iron Studies

2.2.9
Iron studies are used in the evaluation of disorders of iron metabolism and are primarily indicated for the workup of iron deficiency and iron overload.
Iron studies may be reimbursed when the appropriate procedure code is billed with one of the following diagnosis codes:
Procedure code 83550 will be denied if it is billed with the same date of service by the same provider as procedure code 84466. All other iron studies may be reimbursed if they are billed with the same date of service by the same provider.
Modifier 91 may be used if a repeat procedure on the same day by the same provider is medically necessary.
Refer to:
The appropriate Texas Medicaid fee schedule on the TMHP website at www.tmhp.com for iron studies procedure codes that may be reimbursed.

Texas Medicaid & Healthcare Partnership
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