Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.
Effective for dates of service on or after October 1, 2019, diagnosis and age restrictions will be updated for clubfoot casting services.
The following procedure codes will be limited to clients ages 3 and younger:
|Procedure Code||Type of Service|
|29540||Ambulatory Surgical Center|
The following diagnosis codes may be reimbursed when submitted with procedure code 29450:
For more information, refer to the Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, And Physician Assistants Handbook, subsection 188.8.131.52, “Clubfoot Casting.”
For more information, call the TMHP Contact Center at 800-925-9126.