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Institutional / UB Manual and Bulletins

 

Institutional/UB Manuals

Institutional Provider Manual (Effective 10.1.20)

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

Tribal Provider Manual (10.1.20)

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 10.1.20
PASRR Manual
MI/MR ICD-10 Diagnosis Code 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
WSH Cert Form 4.1.17
Title 25 State Letter

 

Important Policy Changes/Additions

Manual Updates

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 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)

 

Institutional Bulletins