The applicable copayment amount is automatically deducted from the Wisconsin Medicaid-allowed payment. X-Rays Providers must not bill multiple radiology codes to describe a single service that was provided. Refer to Appendix 5 of this handbook for allowable x-ray procedure codes. When component procedure codes are billed rather than the appropriate CPT-4 procedure code for the sum of the separate procedures, the component procedure codes are cutback or denied. Claims submitted electronically have the same legal requirements as claims submitted on paper and are subjected to the same processing requirements as paper claims.
Providers submitting electronically can usually reduce their claim submission errors.
A sample claim form and completion instructions are in Appendices 1 and 2 of this handbook. Chiropractic services submitted on any other paper form than the HCFA 1500 claim form are denied. The HCFA 1500 claim form is not provided by Wisconsin Medicaid or the fiscal agent. It is available from a number of forms suppliers. The fiscal agent must receive all claims for services rendered to eligible recipients within 365 days from the date of service.