016.06.48-242.190 Prosthetic Devices for Beneficiaries of All Ages
AR ADC 016.06.48-242.190Arkansas Administrative CodeEffective: February 1, 2022
Effective: February 1, 2022
Ark. Admin. Code 016.06.48-242.190
016.06.48-242.190 Prosthetic Devices for Beneficiaries of All Ages
Procedure codes found in this section must be billed either electronically or on paper with modifier EP for beneficiaries under 21 years of age or modifier NU for beneficiaries age 21 and older. When a second modifier is listed, that modifier must be used in conjunction with either EP or NU.
Modifiers in this section are indicated by the headings M1 and M2. Prior authorization requirements are shown under the heading PA. If prior authorization is needed for beneficiaries age 21 and older, that information is indicated with a “Y” in the column; if not, an “N” is shown.
When codes are payable for all ages, “All” is indicated in the column, “U21” is shown when the code is payable only for beneficiaries under age 21 and “21+” is shown when the code is payable only for those beneficiaries age 21 and older.
1 The purchase of this component is limited to one per five-year period for beneficiaries age 21 and over.
* Replacement only
-(...) This symbol, along with text in parentheses, indicates the Arkansas Medicaid description of the product. When using a procedure code with this symbol, the product must meet the indicated Arkansas Medicaid description.
NOTE: Procedure codes for prosthetic eyes and information regarding prosthetic eye care is located in the Arkansas Medicaid Visual Care Program Manual.
View or print the procedure codes and modifiers for Durable Medical Equipment (DME), oxygen equipment and supplies, orthotic appliances, prosthetic devices and medical supplies, procedures and services.
Credits
Amended Nov. 1, 2017; Feb. 1, 2022.
<Editor’s Note: Nonfunctioning links so in original.>
Current with amendments received through May 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.48-242.190, AR ADC 016.06.48-242.190
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