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December 2016 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 : 5.2.9 Implantable Infusion Pumps

5.2.9
Implantable infusion pumps are a benefit of Texas Medicaid. Implantable infusion pumps may be medically necessary in the following circumstances:
An IIP is not a benefit for the following uses:
All supplies associated with an IIP are included with the reimbursement for the surgery to implant the infusion pump and are not reimbursed separately.
Providers may be reimbursed for implantable infusion pumps using procedure codes E0782, E0783, and E0786.
If procedure codes E0782 and E0783 are billed with the same date of service, only one may be reimbursed.
Refer to:
Subsection 9.2.39.22, “Implantable Infusion Pumps,” in the Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook (Vol. 2, Provider Handbooks).

Texas Medicaid & Healthcare Partnership
CPT only copyright 2014 American Medical Association. All rights reserved.