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Institutional / UB Manual and Bulletins

 

Institutional/UB Manuals

Institutional Provider Manual (Effective 7.1.21)

BMS Claims Blackout Comunication

Updated Hearing Aid Criteria

Dental Prior Authorization - Transition Reminder

Nursing Home Swing Bed Billing and PASRR Requirements

Tribal Provider Manual (7.1.21)

Optum Bulletin - Dental iExchange Registration and Trainings

Important Dental Prior Authorization Changes

Fee Schedule - Access this page for Standard Fee Schedule information, the Procedure Code Search page, the Dental Fee Schedule, the Genetic Testing Fee Schedule, and the OPPS Fee Schedule.

TPL Priority Diagnosis List - This is a list of diagnosis codes that must be billed with external cause code(s).  This list includes diagnoses for burns, corrosion, abrasions, contusions, hematomas, crushing injuries, fractures, head injuries, other injuries, spinal injuries, wounds, and lacerations.

Edits EOBs and Resolutions 4.2.20
This is a list of edits that may post when verifying claims in the Secure Web Portal, along with the possible EOB codes that would post on any claim denials.  Each edit and EOB combination has a suggested resolution.


Provider Medicaid and State Health Care Benefit Plan 4.12..21
PASRR Manual
PASRR Level 2 Diagnosis List
LOC Diagnosis and Procedure Codes
APR-DRG Navigant Presentation
DRG Edits and EOBs
DRGs Requiring Prior Authorization


To search for specific information within the PDF document, select Ctrl F on your keyboard and type your keyword in the find box.

 

Title 25

Upcoming T25 Changes Electronic Claims Submission Process
Title 25 Provider Checklist
Provider Memo April Changes 4.1.17
Title 25 Provider Manual 7.1.21
WSH Cert Form 4.1.17
Title 25 State Letter

 

Important Policy Changes/Additions

Manual Updates

Institutional Provider Manual (Effective 4.1.21)
Institutional Provider Manual (Effective 1.1.21)
Institutional Provider Manual (Effective 10.1.20)
Institutional Provider Manual (Effective 7.1.20)
Institutional Provider Manual (Effective 4.1.20)
Institutional Provider Manual (Effective 1.1.20)
Institutional Provider Manual (Effective 10.1.19)
Institutional Provider Manual (Effective 7.1.19)
Institutional Provider Manual (Effective 4.1.19)
Institutional Provider Manual (Effective 1.1.19)
Institutional Provider Manual (Effective 10.1.18)
Institutional Provider Manual (Effective 7.1.18)
Institutional Provider Manual (Effective 4.1.18)
Institutional Provider Manual (Effective 1.1.18)
Institutional Provider Manual (Effective 10.1.17)

Tribal Provier Manual (4.1.21)
Tribal Provider Manual (1.1.21)
Tribal Provider Manual (10.1.20)
Tribal Provider Manual (7.1.20)
Tribal Provider Manual (4.1.20)
Tribal Provider Manual (1.1.20)
Tribal Provider Manual (10.1.19)
Tribal Provider Manual (7.1.19)

Title 25 Provider Manual (4.1.21)
Title 25 Provider Manual (1.1.21)

 

 

Institutional Bulletins

2021 Bulletins

BMS Claims Blackout Communication
Updated Hearing Aid Criteria
Dental Prior Authorization - Transition Reminder
Optum Bulletin - Dental iExchange Reqistration and Trainings
Nursing Home Swing Bed Billing and PASRR Requirements
Wyoming Cancer Program Changes RA Banner
Wyoming Cancer Program Changes and Updates
Wyoming Medicaid Global Maternity Care Policy Changes
Rate Increase July 1, 2021
Ambulance Policy Reminders
Nursing Home Helpful Information
2021 Q&A Sessions - Hurry to Sign Up
General Reminders and Enrollment Updates
Wyoming Department of Health EUR Webinar
Important Enrollment Vendor Transition Clarification
Winter Storm Impacts
Appeals Process Updates and Clarifications
Important Reminder - Diagnosis Code Update Schedule
2021 Q&A Session Coming Next Week
Enrollment Vendor Transition Updates
New Client Elligibility Inquiry Function Now Available
Important Enrollment Vendor Transition Updates
Questions on Prior Authorization with WYHealth
Important Reminder - Provider Updates
Your License has Expired - Immediate Action Needed
835 Transactions for 12/22/2020 & 12/29/2020 Payments Posted
Update Regarding Chiropractic Services
Client Vendor Contact Information RA Banner
Home Health & DME Prior Authorization Requirement Reinstatement - Corrected
Wyoming Medicaid Requires Postpartum Care Reporting Code

 

2020 Bulletins

Telehealth Updates for Originating Sites
Urgent! December Payment Date Changes - Medicaid
CARES Act Funding for Mental Health and Substance Abuse Services
2020 1099 and W-9 Update Reminder
LT101 and Nursing Home Claims Reprocessing 11.13.20
Medicaid Budget Reduction Changes
Medicaid Behavioral Health Rate Coding and Threshold Changes
Home Health and DME Prior Authorization Requirement Reinstatement
WY COBA Duplicate Claims Issues Postcard
LT101 & NH Claims Reprocessing Postcard
Processing CHIP PA Requests for 10.1.2020 DOS
Upcoming T25 Changes Electronic Claims Submission Process
Kid Care CHIP is Changing RA Banner
Kid Care CHIP is Changing
Q3014 Denial Resolution RA Banner
2020 Provider Workshops Bulletin
Discontinuation of PA Approval and Denial Paper Letter
In-State Physician's License End Date RA Banner
Pharmacy Electronic PAs Submission 4.7.20
COVID-19 Ambulance Changes 3.27.20
iEchange Registration Reminder RA Banner
WYhealth iExchange Registration 4.29.20
Changes to Botox, Dysport, and Myobloc Requirements
Optum Bulletin - PA Vendor Transition Apr 2020
Additional updates to Nursing Home and Swing Bed PASSR Requirements 4.8.20
Home Health COVID-19 Telehealth 4.1.20
Prior Authorization Vendor Transition 4.2.20
Revised Nursing Facilities COVID-19 PASRR 3.31.20
Nursing Facilities COVID-19 PASRR Changes 3.27.20
FQHC/RHC Tribal Facilities Telehealth 3.20.20
BH Peer Specialist via Telehealth 3.20.20
BH Group Therapy via Telehealth 3.18.20
New WY Medicaid Pregnacy Care Reporting Code
COVID-19 Testing Codes RA Banner
WY Medicaid COVID-19 Update Postcard
WCP Dx Code Rebilling RA Banner
LARC Billing and Reimbursement
New Behavioral Health Modifier Requirement
Medicare Crossover Policy Change
UPDATED Policy Enteral Nutrition and Incontinence Supplies