Tag - genetic testing

Provider Alert!
27May

Provider Alert! Cystic Fibrosis and Spinal Muscular Atrophy Screening Authorization No Longer Required

Date: May 27, 2021 Attention: Obstetric Care Providers Effective Date: June 1, 2021 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) would like to inform network providers that beginning June 1, 2021; a prior authorization is no longer required for the...

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Provider Alert!
30Mar

Provider Alert! Genetic Testing Prior Authorization Requirement Reminder

Date: March 26, 2021 Attention: All Providers 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) would like to remind network providers that all genetic testing requires an approved prior authorization before the laboratory tests can be completed. Quest Diagnostics is...

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Provider Alert!
19Nov

Provider Alert! Updates to Prior Authorization Requirements for Genetic Testing, Wheelchair accessory, and Personal Care Services

Attention: All providers Effective Date: March 1, 2021 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) would like to inform network providers of services that require a prior authorization effective March 1, 2021. Genetic Testing Codes: 81202 APC (adenomatous polyposis coli) (eg,...

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Provider Alert!
28Jul

Provider Alert! Age and diagnosis restrictions for Code J0180

Attention: Geneticists Effective Date: July 28, 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) and there is no authorization requirement for Fabrazyme Injection, agalsidase beta Code J0180. TCHP does apply...

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Provider Alert!
12Jun

Provider Alert! Updated reimbursement information for Inpatient Genetic Services

Attention: Geneticist Effective Date: May 1, 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: TCHP would like to inform you of a recent update to the reimbursement information for inpatient genetic service codes 99254 and 99255. Effective for dates of service on or after...

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17Jan

Reminder on obtaining an authorization for genetic testing

Quest Diagnostics is the exclusive contracted lab for TCHP. For OB providers, all genetic testing requires prior authorization. Link to all services that require prior authorization: http://www.texaschildrenshealthplan.org/sites/default/files/pdf/Pre-Certification%20Requirements%20JULY%202017.pdf

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