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Update to "Benefit Update for Reconstructive and Cosmetic Procedures for the CSHCN Services Program"
Information posted September 18, 2008: This is an update to an article that was published on this website on August 8, 2008, titled "Benefit Update for Reconstructive and Cosmetic Procedures for the CSHCN Services Program." The article stated that breast reconstruction following a medically necessary mastectomy will be diagnosis-restricted. The same diagnosis restrictions will also apply to mastectomies.
Effective October 1, 2008, mastectomy procedure codes 2/F-19301, 2/F-19302, 2/F 19303, 2/F-19304, 2/F-19305, 2/F-19306, and 2/F-19307 will be restricted to the following diagnosis codes: 1740, 1741, 1742, 1743, 1744, 1745, 1746, 1748, 1749, 1750, 1759, 19881, 2330, and V103.
For more information, call the TMHP-CSHCN Services Program Contact Center at 1 800-568-2413.
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