Provider Alert! Prior Authorization guidelines for Manual Wheelchair Accessory Code E2227

Provider Alert!

Provider Alert! Prior Authorization guidelines for Manual Wheelchair Accessory Code E2227

Attention: All Providers
Effective Date: June 23, 2020

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.

Call to action: Texas Children’s Health Plan (TCHP) aligns with the Texas Medicaid Provider Procedures Manual (TMPPM) regarding the authorization requirements for Code E2227, manual wheelchair accessory, and gear reduction drive wheel, each. Per TMPPM, the limit is one every five years.

References:
TMPPM DME and Supplies
TCHP Wheelchair Guidelines

How this impacts providers: Provider offices should utilize the Standard Prior Authorization Form for their patients wheelchairs and accessories.

 

Next steps for providers: Providers should follow the prior authorization guidelines and inform their staff.

 

If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.
For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers

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