Institutional / UB Manual and Bulletins

 

Institutional/UB Manuals

Institutional Provider Manual (Effective 4.1.24)

Tribal Provider Manual (Effective 4.1.24)

Important! All Providers – PA Claim Denials & Waiver Denials for Medicare (Effective 5.17.2024)

Important! FQHC/RHC/IHS Encounter Claim Denials (Effective 5.17.2024)

Interpreter Services Update (Effective 4.5.2024)

Partial Units and Claims DDE Warning Message (Effective 3.22.2024)

Immediate Action Needed – EVV Usage Required (Effective 2.23.2024)

Attention ESRD Providers : Update to Rate for January 1, 2024

Wyoming Medicaid’s 2024 Payment Exception Calendar (Effective 1.16.2024)

Update: Medicaid & United Healthcare (UHC) Advantage Plan Part B Denials & Provider Action (Effective 12.22.2023)

Revised Policy! Two (2) Emergency Room (ER) Visits Within 24 Hours (Effective 12.15.2023)

Inpatient Medicare Primary Observation Claims Update (Error Code 7000) (Effective 12.15.2023)

Attention Home Health Providers – Immediate Action Required! (12.12.2023)

1099 Forms – Verification of Mailing Addresses (Effective 12.8.2023)

Home Health EVV Announcement (Effective 10.16.2023)

Update: ESRD Reimbursement Effective Date (Effective 9.25.2023)

Two (2) Emergency Room Visits on the Same Date of Service – Appeal Process (Effective 9.25.2023)

Medicaid & United Healthcare (UHC) Advantage Plan Part B Claim Denials (Effective 8.24.2023)

Updated Coverage of Cologuard (Effective 8.21.2023)

Implementation of 277CA Functionality in BMS (Effective 7.27.2023)

New ESRD Payment Methodology and Billing Requirements (Effective 7.24.2023)

New Requirements for Nursing Homes Providers (Effective 5.30.2023)

Reprocessing of Paid Outpatient Claims (OPPS) (Effective 5.25.2023)

Provider Taxonomy Requirements when Billing Medicare for Dually Eligible Members (Effective 5.9.2023)

Discontinuance of Call Center Services for Billing Agents/Clearinghouses and their Third-Party Vendor Calls (Effective 3.14.2023)

Adverse Childhood Experiences (Effective 3.8.2023)

Condition Code Update (2.13.2023)

Billing Provider Taxonomy Requirements (Effective 1.6.2023)

January 2023 WY Medicaid Mandating Use of Value Codes 80 and 81 (Effective 12.30.2022)

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.

Provider Medicaid and State Health Care Benefit Plan (10.19.21)

APR-DRG Navigant Presentation

DRGs Requiring Prior Authorization

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

OPPS Fee Schedule - Access this page specifically for the APC-based Fee Schedules for the Outpatient Prospective Payment System (OPPS).

LOC Diagnosis and Procedure Codes

Medicaid Pregnancy and Post-Partum Care Billing Infographic

PASRR Level 2 Diagnosis List

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.

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