Procedure codes W7091-W7094 are only allowable if V23.9 is indicated. If billing for more than one month of activities, or more than one procedure code, use one detail line for each month s activities with the date of service determined as described below. Refer to Appendix 5 of this handbook for Medicaid-allowable POS codes. Claims received without an appropriate procedure code are denied by Wisconsin Medicaid. Refer to Appendix 4 of this handbook for definitions of modifiers.
Charges Enter the total charge for each line item.
Element 24G Days or Units Enter the appropriate number of hours billed on each line. Round to the nearest 0.1 hour. Appendix 6 of this handbook lists the rules for rounding. If HealthCheck or family planning do not apply, leave this element blank. Optional - provider may enter up to 12 characters of the patient s internal office account number.