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Provider Manuals


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Forms
Manuals
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Software
HIPAA Tools
Name Description
Carrier Codes Carrier Code abbreviations used by Vermont Medicaid.
Chronic Care Diagnoses Catamount Health-Chronic Care wrap-around diagnosis codes.
Clinical Resources Billers, please follow this link to clinical guidelines and other clinical resources.
CMS 1500 Supplement Provider manual with billing instructions for the CMS 1500 claim form.
Dental Fee Schedule Schedule of Dental Fees
Dental Supplement Provider Manual with billing instructions related to the dental claim
DME Restrictions Current DME codes with each restriction, allowable modifier and unit limitation.
EOB Codes X-walk Vermont Medicaid non-compliant EOB codes cross walked to HIPAA-compliant adjustment reason codes.
Fee Schedules Fee Schedule of CPT/HCPCS Codes.
Ladies First Provider Resource & Training Website Link to http://ladiesfirstproviders.vermont.gov
MedSolutions/Radiology Management Link to http://www.medsolutions.com/implementation/vtmedicaid/index.html to view: Provider Orientation & Quick Reference Guide and CPT codes requiring Prior Authorization (PA). PA is required for all elective outpatient CT, MR & PET scans performed on or after 9/1/2010. Diagnostic Imaging Program Guidelines
OPPS Revenue code requiring HCPCS/CPT All active revenue codes marked with Yes require CPT/HCPCS coding. THE PREPARATION FOR THE IMPLEMENTATION OF OPPS PRICING HAS NOT CHANGED VERMONT MEDICAID POLICY REGARDING NON-COVERED SERVICES
PA Supplement The Prior Authorization Supplement contains billing and policy information. Please refer to the Fee Schedule for the procedure codes that require prior authorization.
Provider Manual Base Provider Manual which contains info related to policy and eligibility
Psychiatric Inpatient Supplement Procedures Manual for Psychiatric Inpatient Services
Relative Weights Vermont-based Relative Weights Vermont-based Relative Weights effective October 1, 2011.
837 Adjustment Reason Codes A list of adjustment reason codes accepted electronically, when denied by a third party payer.
UB 04 Provider manual with billing instructions for the UB04 claim form.
X12N guides Website where the HIPAA X12N Implementation Guides can be found and downloaded.
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