MO HealthNet Professional Billing Book

The MO HealthNet Professional Billing Book contains information to help providers submit claims correctly to the MO HealthNet program. The information is recommended only for MO HealthNet providers and billers whose MO HealthNet provider numbers begin with 20, 24, 25, 30, 35, 42, 50, 51, 52, 54, 55, 70, 71, and 91. 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 2010 (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).

• Introduction: Cover Page, Preface and Table of Contents Updated 08/03/11
• Section 1: MO HealthNet Program Resources Updated 08/03/11
• Section 2: CMS-1500 Claim Filing Instructions Updated 08/03/11
• Section 3: Injection (Pharmacy) Claim Filing Instructions Updated 08/03/11
• Section 4: Medicare/MO HealthNet Claims Updated 02/08/11
• Section 5: The Remittance Advice Updated 08/03/11
• Section 6: Pre-Certification for Radiological Services Updated 04/28/11
• Section 7: Adjustments Updated 08/03/11
• Section 8: Healthy Children and Youth Program Updated 08/03/11
• Section 9: Maternity Care and Delivery Updated 04/28/11
• Section 10: Family Planning Services Updated 08/03/11
• Section 11: Surgery Updated 04/28/11
• Section 12: Anesthesia Updated 04/15/10
• Section 13: Office Supply Codes Updated 08/03/11
• Section 14: Prior Authorization Updated 08/03/11
• Section 15: Laboratory Services Updated 05/07/09
• Section 16: Resource Publications for Providers Updated 08/03/11
• Section 17: Participant Liability Updated 08/03/11

The complete MO HealthNet Professional Billing Book updated 08/03/11, 74 pages, file size: 1.77MB*

* Large file. Depending on your connection speed, download may take several minutes.