The following tables show the section and handbooks that were changed in the CSHCN Services Program Provider Manual. The changes are listed in reverse chronological order (newest first).
To see the changes made in 2019, see the 2019 Release Notes.
December 2020 CSHCN Release Notes |
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Chapter |
Related Articles and Notes |
Revised the order of "Waste, Abuse, and Fraud" to "Fraud, Waste and Abuse," to align with the HHSC website language. |
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Chapter 5: Claims Filing, Third-Party Resources, and Reimbursement |
Moved place of service codes 55 and 56 from Inpatient Hospital to Outpatient Hospital. |
Removed language regarding separate enrollment for audiologists in section 20.1.1, "Non-Implantable Hearing Aid Devices and Services." |
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Update to CSHCN Program Provider Manual Neurostimulators and Neuromuscular Stimulators Removed add-on procedure codes 61782 and 61783 from sections 27.2.1, "Dorsal Column Neurostimulation (DCN)," 27.2.2, "Intracranial Neurostimulation (ICN)," and 27.2.11, "Revision or Removal of Implantable Neurostimulators." Revised procedure code L8633 as L8683 in section 27.2.12, "Implantable Neurstimulators and Neuromuscular Stimulators." Added reimbursement statement, "The purchase of supplies for NMES/TENS may only be considered for reimbursement for clients with a purchased device and a claims history of a NMES/TENS procedure within the last 5 years," to section 27.2.12.2, "NMES and TENS Supplies." |
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Reimbursement Rate Updates for Procedure Code J7169 for the CSHCN Services Program |
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Added benefit limitation statement, "Procedure code T2002 is not allowed without a PPECC service procedure code billed on the same day by the same provider," to section 33.6, "Reimbursement." |
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Added benefit limitation statement, "Procedure codes A4556 and A4557 for the CRM may be reimbursed for clients with a purchased monitor, procedure code E0618 or E0619, within the last 5 years." |
November 2020 CSHCN Release Notes |
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Chapter |
Related Articles and Notes |
Updated phone and fax numbers for regional offices throughout chapter. |
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ICD-10 Special Bulletin, No. 18 |
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Benefit limitation language added for procedure codes D4283 and D4285 in the table of section 14.2.6.6, "Periodontics." Benefit limitation language added to dental caries reimbursement statement in section 14.2.3.2, "Clinical Oral Evaluations." |
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ICD-10 Special Bulletin, No. 18 |
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ICD-10 Special Bulletin, No. 18 |
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ICD-10 Special Bulletin, No. 18 |
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ICD-10 Special Bulletin, No. 18 Update to TMPPM and CSHCN Services Program Provider Manual for Pediatric Pneumogram Limitation |
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ICD-10 Special Bulletin, No. 18 |
October 2020 CSHCN Release Notes |
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Chapter |
Related Articles and Notes |
Removed "Access device when necessary," and "Mounting device when necessary," from the bulleted list in section 10.2 to align with medical policy. |
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CSHCN Dental Therapeutic Services Benefit Changes, Effective September 1, 2020 Broken link to First Dental Home webpage replaced with updated link. |
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Wheelchair Seating Evaluation Form Guidelines to be Updated for the CSHCN Services program October 1, 2020 |
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Added procedure code J2505 and limitation to the table in Section 31.2.25.5, "Injection Procedure Codes." |
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Benefit Limitation Updated for Respiratory Equipment and Supplies Procedure Code A4216 |
July 2020 Release Notes |
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Chapter |
Related Articles and Notes |
Chapter 13: Certified Respiratory Care Practitioner (CRCP) |
Related Articles: |
June 2020 Release Notes |
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Chapter |
Related Articles and Notes |
Chapter 2: Provider Enrollment and Responsibilities |
Related Articles: |
Chapter 31: Physician |
Related Articles: |
May 2020 Release Notes |
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Chapter |
Related Articles and Notes |
Chapter 1: TMHP and HHSC Contact Information |
Notes: |
Chapter 4: Prior Authorizations and Authorizations |
Notes: |
Chapter 5: Claims Filing, Third-Party Resources, and Reimbursement |
Notes: Updated Filing Deadline Calendars in Sections 5.1.8, "Claims Filing Deadlines," and 5.5, "Correction and Resubmission (Appeal) Time Limits." |
Chapter 7: Appeals and Administrative Review |
Notes: Updated Authorization and Filing Deadline Calendars in Sections 7.3, "Claim Appeals," and 7.6, "Authorization and Filing Deadline Calendars." |
Chapter 14: Dental |
Notes: |
Chapter 17: Durable Medical Equipment (DME) |
Notes: |
Chapter 24: Hospital |
Notes: |
Chapter 25: Laboratory Services |
Related Articles: New Quantity Limitation for Procedure Code 87798 |
Chapter 26: Medical Nutrition Services |
Notes: |
Chapter 31: Physician |
Updates to TMPPM and CSHCN Services Program Provider Manual for Genetic Services Reimbursement Criteria for Procedure Codes 99254 and 99255 CSHCN Physician Evaluation and Management Office and Outpatient Services Limitation Language Added |
April 2020 Release Notes |
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Chapter |
Related Articles and Notes |
Chapter 24: Hospital |
Added statement, "procedure code Q4081 is limited to three injections per calendar week (Sunday through Saturday)," to subsection 24.3.7.1, "Exceptions." |
Chapter 31: Physician |
Reimbursement Rate Updates for Some HCPCS Procedure Codes Will Implement for the CSHCN Services Program Developmental Screening and Testing Benefit Limitation Language Updated for the CSHCN Services Program |
Chapter 35: Renal Dialysis |
Added statement, "procedure code Q4081 is limited to three injections per calendar week (Sunday through Saturday)," to subsection 35.3.5, "Unscheduled or Emergency Dialysis in a Non-Certified ESRD Facility." |
March 2020 Release Notes |
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Chapter |
Related Articles and Notes |
Chapter 2: Provider Enrollment and Responsibilities |
Removed PEP option for Hospice and Medical Food providers. |
Chapter 17: Durable Medical Equipment (DME) |
Language update regarding wheelchair power elevating leg lifts and wheelchair power seat evaluation system. |
Chapter 25: Laboratory Services |
Removed invalid procedure code 88235. |
January 2020 Release Notes |
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Chapter |
Related Articles and Notes |
Chapter 4: Prior Authorizations and Authorizations |
Added subsection 4.4.2, “Closing a Prior Authorization.” |
Chapter 31: Physician |
Updated ImmTrac term as ImmTrac2 in subsection 31.2.24.2.1, “DSHS.” |