Wiki Non-Covered by Texas Medicaid

Cuteyr

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Hi,

Some CPT's like 28344 and 69610 are not covered by Texas Medicaid.
Please advice what should be done in these cases .

Thanks in advance
 
well if it is a Mcaid patient then the procedure should not be performed as you cannot charge most Mcaid patients. The 28344 is clearly an elective procedure ans is most likely cosmetic in nature, if not and you have a clear medically necessary reason, then perhaps you should discuss with the Mcid authoritis in your state.
The 69610 is probably considered non essential and they more than likely will pay for a 69210 or the more extensive 69620.
Since this is a system of health care designed to take care of the financially indigent there is a restriction on services that can be performed. You may not agree with it but there it is.
 
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