Manuals page

Provider Manuals

Name	Description
Carrier codes	Listing of Third Party Carriers and Carrier Codes
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
Diagnosis/Surgical Codes	Mapping of new 2008 ICD-9 diagnosis and surgical procedure codes to current codes. This is to be used if hospitals did not purchase grouper software where the mapping is done automatically effective October 1, 2007.
DME Restrictions	Current DME codes with each restriction, allowable modifier and unit limitation.
DRG Q&A	Questions and Answers for providers pertaining to DRG payment methodology.
2007 E & M Rates	Updated list of RBRVS rates.
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.
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.
Vermont Medicaid Pre-Procedure Request Form	Pre-Procedure Request form. Pages 1 & 2 are mandatory and pages 3 & 4 are to be used when applicable.
OPPS Provider Bulletin for Outpatient Hospital Billers	Important OPPS Provider Bulletin for Outpatient Hospital Billers
Provider Manual	Base Provider Manual which contains info related to policy and eligibility
Relative Weights	Vermont-based Relative Weights effective 01/01/2008 through 09/30/2008. Vermont-based Relative Weights effective October 1, 2008.
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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