Prior Authorization Update for Incontinence Supplies Procedure Code A6250

Date: May 7, 2024

Attention: All Providers

Effective: April 10, 2024

Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers of a prior authorization update for incontinence supplies procedure code A6250, skin sealants, protectants, moisturizers, and ointments, any type, any size.

Procedure code A6250 is indicated to treat the following:

Incontinence-associated dermatitis

Effective April 10, 2024, prior authorization is required for procedure code A6250 for members 0-3 years of age.

Providers can review prior authorization criteria and additional information regarding procedure code A6250 in the current Texas Medicaid Provider Manual (TMPPM), Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook, section 2.2.15.1, “Skin Sealants, Protectants, Moisturizers, and Ointments for Incontinence-Associated Dermatitis”

Next step for providers: Providers should share this prior authorization update with their staff.

If you have any questions, please email Provider Relations at:providerrelations@texaschildrens.org.

For access to all Provider Alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.