The purpose of this letter is to notify nursing facility providers that effective February 1, 2016, assessments, completed on or after February 1, 2016, to determine whether a Medicaid eligible, positive Preadmission Screening and Resident Review (PASRR) resident with IDD would benefit from a Custom Manual Wheelchair (CMWC), must now be billed as a separate service using the information provided below. Providers should refer to the Long Term Care (LTC) Bill Code Crosswalk for complete details. To ensure the Texas Medicaid & Healthcare Partnership (TMHP) does not deny a claim for services due to a lack of authorization, nursing facility providers should continue to review the resident’s Medicaid Eligibility and Service Authorization Verification (MESAV) to verify a service authorization has been created before billing. PASRR CMWC Assessment Billing Codes effective February 1, 2016 BILL CODE DESCRIPTION SERVICE GROUP SERVICE CODE PROCEDURE CODE QUALIFIER CPT CODE REVENUE CODE G0481 CMWC ASSESSMENT BY OT CONTRACTED (PASRR) 1 8C HC 97542 0434 G0973 CMWC ASSESSMENT BY OT STANDARD (PASRR) 1 8C HC 97542 0434 G0482 CMWC ASSESSMENT BY PT CONTRACTED (PASRR) 1 7C HC 97542 0434 G0974 CMWC ASSESSMENT BY PT STANDARD (PASRR) 1 7C HC 97542 0434 For assistance regarding PASRR billing
Visit us at Garlo Ward, PC.