Vitamin B12 (Cyanocobalamin) Injections for Texas …

1 Vitamin B12 ( cyanocobalamin ) Injections for Texas medicaid Information posted November 21, 2014 Note: This article applies to claims submitted to tmhp for processing. For claims processed by a medicaid managed care organization (MCO), providers must refer to the MCO for information about benefits, limitations, and reimbursement. Effective for dates of service on or after October 1, 2015, tmhp will implement the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis coding changes as directed by the Centers for Medicare & medicaid Services (CMS). In preparation for the implementation of the ICD-10-CM diagnosis code changes, tmhp , the Texas Health and Human Services Commission (HHSC), and the Texas Department of State Health Services (DSHS) are updating medical policies to include proposed ICD-10-CM diagnosis codes that will be effective for dates of service on or after October 1, 2015.

2 Important: At this time, the list or lists in this article that identify the ICD-10-CM replacements for specific International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes may not be all-inclusive. As medical policies continue to update, the list or lists of ICD-10-CM diagnosis codes for specific benefits are subject to change. Providers will be notified if lists change. tmhp has created the ICD-10 Benefit Updates web page to inform providers of ICD-10-CM benefit updates as they become available. Benefit changes will be added to this new web page each week. Providers are encouraged to refer to this page regularly for the most up-to-date information.

3 Vitamin B12 ( cyanocobalamin ) Injections Effective for dates of service on or after October 1, 2015, Vitamin B12 (procedure code -J3420) may be reimbursed when submitted with one of the following ICD-10-CM diagnosis codes: Diagnosis Codes (Submitted as stand-alone diagnosis codes) B700 D510 D511 D512 D513 D518 D520 D521 D528 D529 D531 D649 E538 E710 E71110 E71111 E71118 E71120 E71121 E71128 E7119 E712 E7210 E7211 E7212 E7219 E723 E7251 E7259 E728 G621 G63 H4611 H4612 H4613 H463 K5660 K900 K901 K902 K903 K9089 K909 K911 K912 Z903 Z9221 Z980 For the list of diagnoses in the table above, the client s medical record must include documentation that indicates why the client was unable to be treated with oral therapy.

4 Providers may refer to The Texas medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physicians Assistants Handbook, subsection Vitamin B12 ( cyanocobalamin ) Injections , for more information. For more information, call the tmhp Contact Center at 1-800-925-9126.