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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 : 2.2.10 Genetic Testing for Colorectal Cancer : 2.2.10.1 Documentation Requirements

2.2.10.1
Providers must maintain the following documentation in the client’s medical record for genetic testing for colorectal cancer:
The provider must order the test based on the familial medical history and the availability of previous family testing results. The medical record is subject to retrospective review.
Refer to:
The appropriate Texas Medicaid fee schedule on the TMHP website at www.tmhp.com for genetic testing procedure codes that may be reimbursed.

Texas Medicaid & Healthcare Partnership
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