016.06.48-242.180 Orthotic Appliances for Beneficiaries of All Ages
AR ADC 016.06.48-242.180Arkansas Administrative CodeEffective: February 1, 2022
Effective: February 1, 2022
Ark. Admin. Code 016.06.48-242.180
016.06.48-242.180 Orthotic Appliances 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 individuals age 21 and older, that information is indicated with a “Y” in the column; if not, an “N” is shown. When prior authorization is not applicable (for U21) that information is shown with an “N/A” in the column.
When codes are payable for all ages, “All” is indicated in the column, “U21” is shown when the code is payable only for individuals under age 21 and “21+” is shown when the code is payable only for those individuals age 21 and older.
** This item is not a covered service for the diagnosis of Carpal Tunnel Syndrome prior to surgery.
-(...) 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.
◼ This procedure code does not require prior authorization; however, the beneficiary's medical condition must fall within the following diagnosis codes. (View ICD codes.)
+ This item is limited to one every twelve months for beneficiaries age 21 and over.
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 Aug. 15, 2018; 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 016.06.48-242.180, AR ADC 016.06.48-242.180
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