Provider Alert! Diagnosis and Age Restrictions to Change for Hydroxyprogesterone Caproate Procedure Code J1729
Date: August 9, 2023
Attention: OB Providers
Effective date: August 1, 2023
Call to action: Texas Children’s Health Plan (TCHP) would like to make providers aware of changes made to Hydroxyprogesterone Caproate, Procedure Code J1729.
How this impacts providers: Changes are as follows:
- Effective August 1, 2023, diagnosis codes O09211, O09212, O09213, and O09219 will be removed as payable diagnoses for hydroxyprogesterone caproate (procedure code J1729).
- Procedure code J1729 will no longer be age restricted.
- Procedure code J1729 will be restricted to clients who are non- pregnant women when billed with the following diagnosis codes:
- C541
- N897
- N910
- N911
- N912
- N925
- N938
Next step for Providers: Providers should communicate this information with their staff.
If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.
For access to all provider alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers
