Flu Season Alert!Alerta de temporada de influenza:
Don’t let germs win this season – protect yourself and your family!
The flu vaccine is your best defense against flu and related complications – PLUS, it is a covered benefit for Texas Children’s Health Plan members! Learn more!
¡No permitas que los gérmenes ganen esta temporada! ¡Protégete a ti y a tu familia!
La vacuna contra la influenza es tu mejor defensa contra la influenza y sus complicaciones. Además, ¡es un beneficio cubierto para los miembros de Texas Children's Health Plan! Aprende más
Information posted May 5, 2017
Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.
Effective for dates of service on or after May 5, 2017, laboratory providers must include modifier U4 with procedure code 86790, 87798, or 87799 when submitting a claim for Zika virus testing.
Procedure Codes
Modifier
Special Instruction
86790, 87798, 87799
U4
Use for Zika virus testing*
*Prior authorization is not required for Zika virus testing.
Important: To ensure laboratories are able to submit Zika virus testing claims correctly, the ordering provider must clearly indicate when a test is for Zika virus screening.
For more information, call the TMHP Contact Center at 1-800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 1-800-568-2413.
