23 MAC Pt. 202, R. 4.4.C.2
5
Cite as 23 Miss. Admin. Code Pt. 202, R. 4.4.C.2
5. Provisions listed in Miss. Admin. Code Part 202, Rule 4.4 apply to transplant services on
or after October 1, 2012.
6. Transplant services not available in Mississippi and not listed in the Milliman’s U.S.
Organ and Tissue Transplant Cost Estimates and Discussion will be reimbursed using
the Mississippi APR-DRG payment methodology. If the Mississippi APR-DRG payment
limits access to care, the Division of Medicaid will reimburse what the domicile state
pays for the service.
D. All conditions of third party liability procedures must be satisfied.
E. All claims must be submitted according to the requirements of the Mississippi Medicaid
program.
F. All charges, both facility and physician, relating to procurement/storage must be billed by the
transplant facility on the current uniform billing (UB) claim form with the appropriate
revenue code(s).
G. The Division of Medicaid reimburses all facility and physician charges relating to the
procurement of an organ, whether from a cadaver or a living donor, to the transplant facility
using the appropriate revenue codes.