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Texas Medicaid Modifiers-Does anyone have

  1. #1
    Default Texas Medicaid Modifiers-Does anyone have
    Medical Coding Books
    Does anyone have links or research sources they could share regarding Tx Medicaid modifiers and any guidelines for assignment/coding.

    Medicaid is a new entity for me; so any resources would be greatly appreciated.

    Thank you

  2. Default Texas Medicaid
    http://www.tmhp.com/TMPPM/2011/Vol1_...ims_Filing.pdf

    Go to section 6.3.5 Modifiers. It lists the modifiers and any special instructions.

    hope this helps

    LM

  3. #3
    Default
    There's also this:
    http://www.tmhp.com/HTMLmanuals/TMPP...PM-07-039.html

    What I can tell you about them, is that TMHP is weird about modifiers. For example, we bill testing for both A & B strains of influenza; CPT guidelines, and every other payer in the world, instruct us to bill it as :
    87804
    87804-59

    But TMHP wants it as:
    87804
    87804-91

    Go figure.

    Your best bet is to try to find modifier policies specific to the services you're trying to bill, to figure out what they want you to do. I suggest using a regular search engine to find it (Just type "TMHP coverage..." then your CPT codes and see what you come up with.) It's actually easier to find things that way, than to try to search for them on TMHP's website.

    Once again, go figure. Good luck!

  4. #4
    Default Thank you
    Some light reading for the weekend

    Thank you so much for a great start to research....

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