Department of Vermont Health Access: Speech Generating and Alternative/Augmentative Communication Device: PRESCRIPTION for E2510-12 (Not for use with iPad/iPod devices) November 2016 Beneficiary Name: Medicaid #: ICD-10 Diagnosis Code: AAC Device Type Specifications Medical Necessity Procedure Code Rationale Device: Components Specific Name Vendor Medical Necessity Procedure Code Rationale app name protective case speakers switch switch key guard mounting arm stylus other other
Department of Vermont Health Access: Speech Generating and Alternative/Augmentative Communication Device: PRESCRIPTION for E2510-12 (Not for use with iPad/iPod devices) November 2016 Beneficiary Name: Medicaid #: ICD-10 Diagnosis Code: AAC Device Type Specifications Medical Necessity Rationale Procedure Code Device: Components Specific Name Vendor Medical Necessity Rationale Procedure Code app name protective case speakers switch switch key guard mounting arm stylus other other
1aac-forms-only-as-of-012617.docx