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Billing Instructions

Instructions for schools, home health agencies, FQHC's and RHC's offering seasonal and H1N1 vaccine clinics

Memo from Tony Marple 09/09/2009

Word PDF
Provider enrollment form
Sample billing roster  
Billing instructions

You can return the enrollment form by

U.S. Mail: Office of MaineCare Services, State House Station #11, Augusta, ME 04333

E-mail: Provider Enrollment Unit

Fax: 207-287-8450

 

Paper and Electronic Billing and Remittance Advice Instructions Word PDF
     
Paper Billing Instructions:    
Assisted Living - Section 96 - Private Duty Nursing and Personal Care Services (.doc) (.pdf)
CMS 1500 New Form (.doc) (.pdf)
CMS 1500 New Form Sample (.TIF)  
CMS/HCFA 1500 (Old Form) Instructions (.doc) (.pdf)
Dental - 1999 Form (.doc) (.pdf)
Dental - 2006 Form (.doc) (.pdf)
Federally Qualified Health Centers   (.pdf)
Home Health Admit/Discharge Forms (Goes to the Office of Elder Services website)    
Managed Mental Health Care Special Billing Instructions    
  Section 17 Community Support Services (.doc) (.pdf)
  Section 65 Mental Health Services (.doc) (.pdf)
    Crosswalk of New Codes Effective August 1, 2008 to Previous Codes (.doc) (.pdf)
  Section 97 Private Non-Medical Institution Services (Updated 08/05/09) (.doc) (.pdf)
NDC Codes: Roster Billing Instruction for Maine Hospitals (.doc) (.pdf)
Rural Health Centers   (.pdf)
Targeted Case Management Services (Section 13) (.doc) (.pdf)
Telehealth requirements (.doc) (.pdf)
UB-04 (.doc) (.pdf)
UB-92 - General Instructions (.doc) (.pdf)
Revenue codes that require HCPCs (.xls)  
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ICD9 Diagnosis and Procedure (Surgical) Codes List:    
2009: New, Changed or Deleted ICD9 Diagnosis and Procedure (Surgical) Codes (.doc) (.pdf)
2010 ICD9 Diagnosis Code Title Changes   (.pdf)
2010 ICD9 Procedure Code Title Changes   (.pdf)
2010 ICD9 Diagnosis Codes deleted   (.pdf)
J-Code/NDC Code Crosswalk    
  J-Code/NDC Code Crosswalk (leaving website, going to the CMS website)    
     
Code Set Updates    
National Uniform Billing Committee Codes Updates (.doc) (.pdf)
Claim Adjustment Reason Codes and Remittance Advice Remarks Codes Updates (.doc) (.pdf)
HCPC Codes discontinued as of 12/31/09 (.xls)  
HIPAA Compliant Code Cross Walks    
The following documents give the local procedure code and its HIPAA-compliant equivalent. When MaineCare's new claims system begins in 2010, providers will need to use HIPAA compliant codes only.
Ambulatory Care Clinics (Section 3) (.xls)
Children with Cognitive Impairments and Functional Limitations (Section 28) (.doc)
Consumer Directed Attendant Services (Section 12) (.xls)
Community Support Services (Section 17) (.xls)
Day Treatment Services (Section 41) (.xls)
Developmental and Behavioral Evaluation Clinic Services (Section 23) (.xls)
Family Planning Services (Section 30) (.xls)
Federally Qualified Health Centers (Section 31) (.xls)
Home and Community Based Services - Elderly and Adults with Disabilities (Section 19) (.xls)
Home and Community Based Services - Mental Retardation and Autistic Disorders (Section 21) (.xls)
Home and Community Based Services - Mental Retardation and Autistic Disorders (Section 29) (.xls)
Home and Community Based Services - Physically Disabled (Section 22) (.xls)
Home Health Services (Section 40) (.xls)
Occupational Therapy (Section 68) (.xls)
Physical Therapy (Section 85) (.xls)
Physician Services (Section 90) (.xls)
Private Duty Nursing and Personal Care Services (Section 96) (.xls)
Private Non-Medical Institution (PNMI) (Section 97) (.xls)
Rehabilitative Services (Section 102) (.xls)
Rural Health Clinics (Section 103) (.xls)
Speech and Hearing Services (Section 109) (.xls)
Transportation Services (Section 113) (.xls)
VD Screening Clinic Services (Section 150) (.xls)
Vaccinations (.xls)
Vision Services (Section 75) (.xls)
Void and Adjustment Instructions:    
Void Instructions (.doc) (.pdf)
Adjustments Instructions (.doc) (.pdf)
Billing and Adjustments Questions and Answers (.doc) (.pdf)
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Remittance advices:    
What Is A Remittance Advice (RA)? (.doc) (.pdf)

 

Note:If you can not read the above files you can use these links to access Word Viewer for .doc files or Adobe Acrobat for .pdf files.

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