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prostheticssectionii.doc

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prostheticssectionii

Section ii - Prosthetics Contents 200.000 GENERAL INFORMATION 201.000 Arkansas Medicaid Participation Requirements for Prosthetics Providers 201.100 Providers in Arkansas and Bordering States 201.110 Routine Services Provider 201.200 Providers in Non-Bordering States 201.210 Limited Services Provider 202.000 The Prosthetics Provider Role in the Child Health Services (EPSDT) Program 203.000 Documentation Requirements 203.100 Documentation in Beneficiary’s Case Files 203.200 Reserved 203.300 Reserved 204.000 Electronic Signatures 210.000 PROGRAM COVERAGE 211.000 Scope 211.100 Condition for Provision of Services 211.200 Physician’s Role in the Prosthetics Program 211.300 Prosthetics Service Provision 211.400 Prescription and Referral Renewal 211.500 Service Initiation Delays 211.600 Termination of Services 211.700 Exclusions 211.800 Electronic Filing of Extension of Benefits 212.000 Services Provided 212.100 Diapers and Underpads for Individuals Age 3 and Older 212.200 Durable Medical Equipment (DME), All Ages 212.201 (DME) Apnea Monitors for Infants Under Age 1 212.202 (DME) Augmentative Communication Device (ACD), All Ages 212.203 Cochlear Implants for Beneficiaries Under Age 21 212.204 (DME) Electronic Blood Pressure Monitor and Cuff for Beneficiaries of All Ages 212.205 (DME) Enteral Nutrition Infusion Pump and Enteral Feeding Pump Supply Kit for Beneficiaries Under Age 21 212.206 (DME) Home Blood Glucose Monitor, Pregnant Women Only, All Ages 212.207 (DME) Insulin Pump and Supplies, All Ages 212.208 Reserved 212.209 (DME) MIC-KEY Skin Level Gastrostomy Tube (MIC-KEY Button) and Supplies for Beneficiaries of All Ages 212.210 DME MIC-KEY Percutaneous Cecostomy Tube (MIC-KEY button) for Beneficiaries of All Ages 212.211 Reserved 212.212 (DME) Specialized Rehabilitative Equipment, All Ages 212.213 (DME) Specialized Wheelchairs and Wheelchair Seating Systems for Individuals Age Two Through Adult 212.214 Reserved 212.300 Medical Supplies, All Ages 212.400 Nutrition