Subject: Codes: K0108, A9900, and E1399 Wheelchair Guideline

Attention: All Providers Effective Date: October 22, 2020; March 1, 2021 for information pertaining to Code A9900 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. In follow-up to our Provider Alert posted on 7/13/2020 regarding wheelchair accessories, Texas Children’s Health Plan did not implement changes to the current process for prior authorization of codes:  K0108 and E1399.  Effective March 1, 2021, for Code A9900, a prior authorization is required if the amount of miscellaneous DME  supplies and accessories exceeds $500.00. The authorization request must be accompanied by appropriate documentation supporting medical necessity.  These codes will continue to be reviewed on a case-by-case basis. How this impacts providers: No action required. Next steps for providers: Providers should inform their staff of this reminder. If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.For access to all provider alerts,log into: www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.