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December 2016 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 : 2.2.11 Diabetic Equipment and Supplies : Obtaining Equipment and Supplies Through a Verbal or Detailed Written Order
If the dispensing provider does not have a detailed written order then a verbal order is required to be on file until the written order is received from the prescribing provider and before providing diabetic equipment and supplies. The prescribing provider’s order may be a written, fax, electronic, or verbal order and must include:
A detailed written order must be received by the DME supplier within 90 days from the date of the prescribing provider’s signature. The detailed written order for diabetic equipment and supplies is valid for six months from the date of the order or the date of the prescribing provider’s signature, whichever is earlier, for initial orders, and from the start date of renewal orders. In the absence of a start date, then the authorized prescribing signature date will be the beginning date of service.
A completed, detailed written order must be signed and dated by the authorized prescribing provider. The prescribing provider is required to retain a copy of the signed and dated detailed written order in the client’s medical record. The DME provider must retain the original, faxed, photocopied, or electronic, signed and dated detailed written order in the client’s medical record.
A completed detailed written order must contain all the following components:
Before submitting a claim to Texas Medicaid, DME providers must have on file a detailed written order with the required information. No other documentation is required.
Prior Authorization
Prior authorization, when necessary, may be considered with documentation of medical necessity, which must include one of the following:

Texas Medicaid & Healthcare Partnership
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