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December 2016 Texas Medicaid Provider Procedures Manual

Radiology and Laboratory Services Handbook : 2 Independent Laboratory : 2.2 Services, Benefits, Limitations, and Prior Authorization : 2.2.2 Laboratory Handling Fees and Reference Laboratories : 2.2.2.4 Family Planning Laboratory Tests

2.2.2.4
Family planning agencies must use procedure code 99000 with a family planning diagnosis code to bill their laboratory handling charges for laboratory specimens sent out; modifier FP must be omitted. Providers may refer to the appropriate section in the provider manual for instructions for billing family planning services. As with procedure code 99000, only one handling fee may be charged for each laboratory to where the agency sends specimens, regardless of the number of specimens taken.
When family planning test specimens, such as Pap smears, are collected, providers must direct the laboratory to indicate that the claim for the test is to be billed as a family planning service.
Refer to:
Subsection 5.1, “Services, Benefits, Limitations, and Prior Authorization” in the Gynecological and Reproductive Health and Family Planning Services Handbook (Vol. 2, Provider Handbooks) for the complete list of family planning diagnosis codes.

Texas Medicaid & Healthcare Partnership
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