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016.06.48-242.122 Jobst Stocking for Beneficiaries of All Ages

AR ADC 016.06.48-242.122Arkansas Administrative CodeEffective: February 1, 2022

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 48. Prosthetics Provider Manual (Refs & Annos)
Section 242.000. CMS-1500 Billing Procedures.
Section 242.100. HCPCS Procedure Codes.
Effective: February 1, 2022
Ark. Admin. Code 016.06.48-242.122
016.06.48-242.122 Jobst Stocking for Beneficiaries of All Ages
The gradient compression stocking (Jobst) is payable for beneficiaries of all ages. However, before supplying the item, the Jobst stocking must be prior authorized by DHS or its designated vendor. View or print contact information for how to submit the request. Documentation accompanying form DMS-679A must indicate that the beneficiary has severe varicose veins with edema, or a venous stasis ulcer, unresponsive to conventional therapy such as wrappings, over-the-counter stockings and Unna boots. The documentation must include clinical medical records from a physician detailing the failure of conventional therapy. View or print form DMS-679A and instructions for completion.
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; Aug. 1, 2021; 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 016.06.48-242.122, AR ADC 016.06.48-242.122
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