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Family Planning Provider Publications

Family Planning Clinics Provider Publications

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Update Number	Update Topics and Release Date
2017
2017-34	New and Clarified Pharmacy Policy and Claims Submission Requirements, 10/26/17
2017-25	New and Clarified Telehealth Policy, 8/18/17
2017-10	Changes to Billing Policy for Family Planning Clinics, 3/29/17
2016
2016-45	Documentation Requirements for Evaluation and Management Procedure Codes, 10/19/16 November 7, 2016: This Update has been revised since its original publication. Page 2 lists examples of non-verifiable types of phrases for pre-loaded or pre-generated text. The change is indicated in red text.
2016-21	Prior Authorization Will No Longer Be Required for Crinone^® 8% When Used for Certain Indications, 6/7/16
2016-16	Changes to Coverage Policy for Testing for Drugs of Abuse, 4/18/16
2015
2015-51	Clarification of the Completion Instructions for the Consent for Sterilization Form, 10/13/15
2014
2014-79	Changes to Provider-Administered Drugs Carve-Out Policy, 12/16/14
2014-62	Changes to the 1500 Health Insurance Claim Form and Completion Instructions, 10/14/14
2014-51	ForwardHealth Updating the Web-Based Express Enrollment Application Tool to Include Express Enrollment for Family Planning Only Services, 9/10/14
2013
2013-53	Revisions to Payer Sheet for All ForwardHealth Programs as a Result of Changes to Claims Submission Requirements for Wisconsin AIDS Drug Assistance Program, 10/9/13
2013-47	Additional Information and Clarifications Regarding Professional Claims for Compound and Noncompound Drugs, 9/26/13
2013-33	ForwardHealth Will Only Accept the Acknowledgement of Receipt of Hysterectomy Information Form, 6/11/13 *June 28, 2013: This Update* has been revised since its original publication.** To promote clarity, specific form names and numbers have been added to the Acknowledgement of Receipt of Hysterectomy Information Completion Instructions, F-01160A, in Attachment 1. Revisions are indicated in red.
2013-31	Requesting Exemption from Prior Authorization Requirements for Advanced Imaging Services, 6/3/13 *6/4/2013: This Update* has been revised since its original publication.** Information under the "Updating the List of Eligible Providers" heading has changed to reflect Portal solution changes.
2013-05	Procedure Code Changes for Family Planning Only Services, 1/24/13
2013-02	New Modifier for Family Planning Only Services, 1/14/13
2012
2012-46	Changes to Prospective Drug Utilization Review Alerts, 9/11/12
2012-13	Reimbursement Reduction to Professional Services Providers for Certain Services When Provided in a Hospital or Ambulatory Surgery Center, 3/27/12
2012-08	Procedure Code Changes for Family Planning Only Services, 3/21/12
2011
2011-52	Revisions to 1500 Health Insurance Claim Form Instructions Resulting from HIPAA ASC X12 Version 5010 Implementation, 9/14/11
2011-50	Clarification of Sterilization Policy Regarding Retroactive Eligibility, 8/29/11
2011-26	Changes to Newborn Reporting, 4/26/11 *On June 16, 2011, the Newborn Report (F-1165) has been revised since it was originally published in this ForwardHealth Update.* The revised form dated 06/11 is in the Attachment of this Update.
2011-13	Important Information About the National Correct Coding Initiative, 3/1/11
2011-06	Three-Month Supply Drug Policy Changes, 1/1/11
2011-05	Changes to Newborn Reporting, 1/1/11
2011-04	Changes to the Pharmacy Services Lock-In Program, 1/1/11
2010
2010-119	How to Correctly Indicate Modifiers on Claims for Repeat or Separately Identifiable Procedures, 12/1/10
2010-118	Real Time and Provider Electronic Solutions Claim Response Enhancement, 12/1/10
2010-101	New Reimbursement Rates for Certain Radiology Services Effective December 1, 2010, 11/1/10
2010-97	Clarification for Extraordinary Claims Submission for Professional Services, 11/1/10
2010-95	Changes to the Family Planning Waiver Effective November 2010, 11/1/10
2010-92	New Prior Authorization Requirements for Advanced Imaging Services, 10/1/10
2010-90	Reimbursement Reduction for Most Paper Claims Submitted to ForwardHealth, 10/1/10
2010-74	Reminder of Deficit Reduction Act Policy for Prescribers, 8/1/10 *This Update* has been revised since its original publication.** Information about Provider Electronic Solutions software has been corrected. Refer to page 2 of the Update for more information.
2010-72	ClaimCheck Clarification, 8/1/10
2010-69	All HealthCheck Services Are Now Covered Under the BadgerCare Plus Benchmark Plan, 8/1/10
2010-63	Compound and Noncompound Drug Claim Submissions Using the ForwardHealth Portal, 8/1/10
2010-56	Changes to Two Provider-Administered Drug Categories Related to Reproductive Health for Females, 6/1/10
2010-52	Pharmacy Services Covered Under the BadgerCare Plus Basic Plan, 6/1/10 *This Update* has been revised since its original publication.** The Explanation of Benefits code on page 5 has been revised.
2010-39	Coverage of Cervarix^® and Changes to the Coverage of Gardasil^®, 5/1/10
2010-36	Some Males Now Eligible for the Family Planning Waiver, 5/1/10 *This Update* has been revised since its original publication.** The URL to ACCESS has been corrected. See the correct URL indicated in red at the bottom of page 1.
2010-25	New Reimbursement Policies for Immunizations Given to BadgerCare Plus and Medicaid Members, 5/1/10
2010-19	Change in Billing and Reimbursement for a Sterilization Procedure, 3/1/10
2010-04	Quantity Limits for Certain Drugs, 2/1/10
2009
2009-98	Changes to the Three-Month Supply of Drugs Policy, 12/1/09
2009-95	Changes to Early Refill Prospective Drug Utilization Review, 12/1/09
2009-88	Pharmacy Coordination of Benefits Changes, 12/1/09 *This Update* has been revised since its original publication.** Revisions were made on page 1 of this ForwardHealth Update and are indicated in red.
2009-58	New Reimbursement Rates for Certain Professional Services Effective October 1, 2009, 10/1/09 This Update has been revised since its original publication. Information for procedure code 27158 has been corrected. See page 5 of the Attachment for more information.
2009-44	New Location for Submitting the Wisconsin Well Woman Medicaid Determination Form and Form Revisions, 8/1/09 This Update has been revised since its original publication to include the full name of the Wisconsin Well Woman Medicaid Determination form, F-10075 (07/09), and to update the e-mail address for submitting the form.
2009-43	Revised Process for Family Planning Waiver Enrollment Applications, 8/1/09
2009-34	BadgerCare Plus Core Plan for Adults with No Dependent Children-Covered Pharmacy Services, 6/1/09
2009-30	Pharmacy Coordination of Benefits Clarification for Other Coverage Code 4, 5/1/09
2009-25	Clarification of Policy and Reimbursement for Provider-Administered Drugs, 5/1/09
2009-24	Procedure Code Change for Therapeutic, Prophylactic, or Diagnostic Injections, 5/1/09
2009-20	Changes to the Newborn Report Form, 5/1/09
2009-18	ForwardHealth Will Require '01' in the Prescriber ID Qualifier Field on Point-of-Sale Real-Time Pharmacy Claims, 4/1/09
2009-06	Reimbursement Changes for Family Planning Clinics, 2/1/09
2008
2008-216	Provider-Administered Drugs for Members Enrolled in Managed Care Organizations Now Reimbursed by Fee-for-Service, 12/1/08
2008-209	Family Planning-Related Services Covered Under the BadgerCare Plus Core Plan for Childless Adults, 12/1/08
2008-173	Changes to the Newborn Report Form, 9/1/08
2008-159	1 Percent Reimbursement Rate Increase for Non-Institutional Services, 8/1/08
2008-143	Reminder: Tamper-Resistant Prescription Pad Requirement for Drug Prescriptions Effective October 1, 2008, 9/1/08
2008-141	Expanded Review by ClaimCheck, 8/1/08
2008-126	National Drug Codes Required on Claims for Physician-Administered Drugs, 7/1/08
2008-123	Submitting Paper Attachments with Electronic Claims, 7/1/08
2008-122	HealthCheck Information Available Through the ForwardHealth Portal, 7/1/08
2008-102	ForwardHealth Announces Changes to Paper and Electronic Claims Submission for Family Planning Services, 7/1/08
2008-37	2003 Wisconsin Act 272 Requirements for Billing, 5/1/08
2008-22	Reminder: Tamper-Resistant Prescription Pad Requirement Effective April 1, 2008, 3/1/08
2008-18	Limited Supply of Free Tamper-Resistant Prescription Pads Now Available, 2/1/08
2008-11	Procedure Code Changes for Physicians and Related Providers, 2/1/08
2007
2007-112	Covered Services and Drugs for the Renewed Family Planning Waiver, 12/1/07
2007-83	Family Planning Services Under BadgerCare Plus, 11/1/07
2007-82	Specialized Medical Vehicle Services Under BadgerCare Plus, 11/1/07
2007-67	Tamper-Resistant Prescription Pad Requirement Delayed, 10/1/07
2007-65	Tamper-Resistant Prescription Pad Requirement, 9/1/07
2007-41	Guidelines for Certain Reproductive Health Services, 6/1/07
2007-07	Explanation of Benefits Codes Associated with Drug Claims Available on the Medicaid Web Site, 1/1/07
2007-01	Covered Services and Drugs for the Family Planning Waiver, 1/1/07
2006
2006-95	New 1500 Health Insurance Claim Form and Supplemental Instructions, 12/1/06
2006-92	Changes Effective January 1, 2007, for Specialized Medical Vehicle Services Providers and Prescribers, 11/1/06
2006-70	Wisconsin Medicaid Adopting Documentation Guidelines for Evaluation and Management Visits, 8/1/06
2006-68	Facility Reimbursement for Sterilizations Provided to Family Planning Waiver Program Recipients, 8/1/06
2006-58	Wisconsin Medicaid Reimburses Selected Services Provided Through Telemedicine, 6/1/06
2006-19	Modifier "CR" Accepted for Catastrophe/Disaster-Related Crossover Claims 3/1/06
2005
2005-64	Medicare Drug Coverage for Dual Eligibles, 10/1/05
2005-28	Point-of-Sale Enhancement and Claims Submission Requirement for Recipients with Commercial Health Insurance, 5/1/05
2005-07	Procedure Code Updates, 1/1/05
2004
2004-78	Drug Utilization Review and Pharmaceutical Care Services May Be Submitted in the Same Transaction, 9/1/04
2004-65	Training for New and Current Users of Provider Electronic Solutions (PES) Software Offered in September and October, 8/1/04
2004-51	Family Planning Waiver Recipients May Be Eligible for Wisconsin Well Woman Medicaid, 6/1/04
2004-20	Family Planning Waiver program eligibility period and presumptive eligibility reminders, 3/1/04
2003
2003-110	Effective dates for claims submission changes as a result of HIPAA for family planning services, 8/1/03
2003-98	Effective dates for code changes as a result of HIPAA for tuberculosis-related services, 8/1/03
2003-77	Maximum allowable fees increase for family planning clinics, 7/1/03
2003-68	Family Planning Waiver Program policy additions and clarifications, 7/1/03
2003-53	Changes to local codes and paper claims for family planning services as a result of HIPAA, 7/1/03
2003-34	Changes to local codes for tuberculosis-related services as a result of HIPAA, 6/1/03
2003-19	Introducing the Guide to Determining Presumptive Eligibility for Pregnant Women, 3/1/03
2003-10	Wisconsin Medicaid revises Newborn Report form, 2/1/03
2003-08	Wisconsin Medicaid introduces Guide to the Tuberculosis-Related Services Only Benefit, 2/1/03
2003-07	Wisconsin Medicaid revises selected forms for physician services, 1/1/03
2003-01	Wisconsin Medicaid revises prior authorization Physician Attachment (PA/PA), 1/1/03
2002
2002-69	HCPCS screening procedure codes policy, 12/1/02
2002-68	Introducing the Medicaid Family Planning Waiver benefit, 12/1/02
2002-56	Procedure code updates, 10/1/02
2002-55	Revised policy requirements and procedure codes for breast pumps, 9/1/02
2002-53	Wisconsin Medicaid covers procedure code for Lunelle^™, 9/1/02
2002-31	1.095% reimbursement rate increase for non-institutional services, 6/1/02
2002-05	1.065% reimbursement rate increase for non-institutional services, 3/1/02
2001
2001-21	Procedure code changes for family planning clinics, 7/1/01
2001-02	Revision of breast pump coverage, 1/1/01
2000
2000-56	Medicaid abortion coverage remains unchanged with the addition of Mifeprex, 11/1/00
2000-20	One percent reimbursement increase for noninstitutional services — Effective July 1, 2000, 7/1/00
1999
99-38	Coverage of an additional type of breast pump and revised clinical guidelines, 8/6/99
1998
98-35	Procedures added to family planning clinic covered services, 12/1/98
98-17	Two percent reimbursement increase for noninstitutional services, 5/28/98
98-09	Physician office counseling visits and 1995 Wisconsin Act 309, 3/2/98
1997
97-41	Medicaid abortion policy, 12/5/97
97-40	Biennial Budget Increases Reimbursement for Noninstitutional Services — Effective July 1, 1997, 12/3/97
97-24	ThinPrep Pap test, 8/18/97
97-09	Laboratory services added, 2/24/97
97-04	Revised Administrative Rules: Medically Unnecessary Services — Effective March 1, 1997, 01/30/97
1996
96-17	Laboratory services added, 5/23/96
96-07	HIV laboratory screening services added, 3/19/96
96-05	Implantable contraceptive capsules: removal with reinsertion, 3/14/95
96-03	New tuberculosis (TB) benefit, 3/12/96
1995
95-48	IUDs: reimbursement policy and rate changes, 11/20/95
95-17	Prescriptions for specialized medical vehicle (SMV) trips, 5/26/95
95-15	Laboratory services added, 5/22/95
95-14	Contraceptive products, 5/19/95
1992
MAPB-092-008-P	CLIA; New "OI" Codes and Claim Form Instructions for Certified Family Planning Clinics, 11/20/92
MAPB-092-007-P	New HCFA 1500 Claim Forms; 1992 CPT Procedure Codes for Certified Family Planning Clinics, 2/17/92
1987
MAPB-087-006-P	New Claim Form; Place of Service, Type of Service and HCPCS Codes; and new Prior Authorization Form, 9/1/87
MAPB-087-005-P	Implementation Max Fee Schedule for Family Planning Clinic Services, 9/1/87

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