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December 2016 Texas Medicaid Provider Procedures Manual

Gynecological, Obstetrics, and Family Planning Title XIX Services Handbook : 5 Gynecological Health Services : 5.7 Salpingostomy : 5.7.1 Prior Authorization for Salpingostomy

5.7.1
Prior authorization is required for salpingostomy.
The prior authorization request must include documentation of one or more of the following conditions:

Texas Medicaid & Healthcare Partnership
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