Provider Alert! Subject: Codes: K0108, A9900, and E1399 Wheelchair Guideline
Attention: All Providers
Effective Date: October 22, 2020; March 1, 2021 for information pertaining to Code A9900
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.
In follow-up to our Provider Alert posted on 7/13/2020 regarding wheelchair accessories, Texas Children’s Health Plan did not implement changes to the current process for prior authorization of codes: K0108 and E1399. Effective March 1, 2021, for Code A9900, a prior authorization is required if the amount of miscellaneous DME supplies and accessories exceeds $500.00. The authorization request must be accompanied by appropriate documentation supporting medical necessity. These codes will continue to be reviewed on a case-by-case basis.
How this impacts providers: No action required.
Next steps for providers: Providers should inform their staff of this reminder.
If you have any questions, please email Provider Network Management at: firstname.lastname@example.org.