MO HealthNet Hospital Billing Book

The MO HealthNet Hospital Billing Book contains information to help providers submit claims correctly to the MO HealthNet program. The information in this book is only for persons who are submitting claims for hospitals that are enrolled providers in the MO HealthNet program. The book is not all inclusive of program benefits and limitations. Providers should refer to specific program manuals for complete information.

CPT codes, descriptions and other data are copyright 2012 (or other such date of publication of the CPT) of the American Medical Association. All Rights Reserved. CPT is a trademark of the American Medical Association (AMA).

Select a topic to view individual sections, or you may download the complete book below. All files are in PDF.

• Introduction: Cover Page, Preface and Table of Contents updated 06/19/13
• Section 1: MO HealthNet Program Resources updated 06/19/13
• Section 2: UB–04 Claim Filing Instructions — Inpatient Hospital updated 11/28/12
• Section 3: Revenue Codes – Inpatient updated 07/25/11
• Section 4: Inpatient Hospital Certification Reviews updated 11/28/12
• Section 5: UB–04 Claim Filing Instructions – Outpatient Hospital updated 11/28/12
• Section 6: Revenue Codes – Outpatient Hospital Facility updated 11/28/12
• Section 7: Outpatient Therapy Procedures updated 11/28/121
• Section 8: The Remittance Advice updated 11/28/12
• Section 9: Medicare/MO HealthNet Crossover Claims updated 11/28/12
• Section 10: Medical Pre–certification for Radiological Procedures updated 11/28/12
• Section 11: Pharmacy Claims updated 04/24/13
• Section 12: Frequently Asked Questions updated 01/15/13
• Section 13: Adjustments & Resubmissions updated 11/28/12
• Section 14: Participant Liability updated 05/02/13
• Nondiscrimination Policy Statement updated 05/02/13

The complete MO HealthNet Hospital Billing Book updated 06/19/13