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CMS 1500 Provider Manual and Bulletins

 

CMS 1500 Provider Manual

CMS-1500 Provider Manual (Effective 10.1.20)

Home Health and DME Prior Authorization Requirement Reinstatement

WY COBA Duplicate Claims Issues Postcard

Processing CHIP PA Requests for 10.1.2020 DOS

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.

ECSII CASII Policy and Billing Information

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 10.01.20

Wyoming Cancer Program (WCP) - Access this website for detailed provider information, including covered Diagnosis (DX) Codes and CPT Codes, for the Breast & Cervical Cancer (BCC) and Colorectal Cancer (COLR) Screening Programs.

New CPT Codes Supplemental Guidiance 1.9.19


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

 

Important Policy Changes/Additions

Manual Updates

CMS-1500 Provider Manual (Effective 7.1.20)
CMS-1500 Provider Manual (Effective 4.1.20)
CMS-1500 Provider Manual (Effective 1.1.20)
CMS-1500 Provider Manual (Effective 10.1.19)
CMS-1500 Provider Manual (Effecitve 7.1.19)
CMS-1500 Provider Manual (Effective 4.1.19)
CMS-1500 Provider Manual (Effective 1.1.19)
CMS-1500 Provider Manual (Effective 10.1.18)
CMS-1500 Provider Manual (Effective 7.1.18)
CMS-1500 Provider Manual (Effective 4.5.18)
CMS-1500 Provider Manual (Effective 4.1.18)

 

 

CMS 1500 Provider Bulletins

2020 Provider Bulletins

Home Health and DME Prior Authorization Requirement Reinstatement
`WY COBA Duplicate Claims Issues Postcard
Processing CHIP PA Requests for 10.1.2020 DOS
Kid Care CHIP is Changing
Q3014 Denial Resolution RA Banner
DD Waiver Survey Reminder RA Banner
2020 Provider Workshops Bulletin
Discontinuation of PA Approval and Denial Paper Letter
Attention Behaviroal Health Provider - Peer Specialist Update
In-State Physician's License End Date RA Banner
Pharmacy Electronic PAs Submission 4.7.20
Home Health COVID-19 Telehealth 4.1.20
COVID-19 Ambulance Changes 3.27.20
iExchange Registration Reminder RA Banner
WYhealth iExchange Registration 4.29.20
Changes to Botox, Dysport, and Myobloc Requirements
Optum Bulletin - PA Vendor Transition Apr 2020
Prior Authorization Vendor Transition 4.2.20
New WY Medicaid Pregnancy Care Reporting Code 3.23.20
BH Group Therapy via Telehelath 3.18.20
BH Peer Specialist via Telehealth 3.20.20
FQHC/RHC Tribal Facilities Telehealth 3.20.20
COVID-19 Testing Codes RA Banner 3.19.20
WCP Dx Code Rebilling RA Banner 2.27.20
LARC Billing and Reimbursement 2.12.20
New Behavioral Health Modifier Requirement 1.30.20
Updated Policy Enteral Nutrition and Incontinence Products 1.21.20