Print this page

The following PDF downloads are the original handbook pages. You will need Adobe Acrobat Reader to view and print these pages. Learn about Acrobat Reader.

Handbook Cover - PDF (249kb)

Table of Contents - PDF (53kb)

Preface - PDF (104kb)

General Information - PDF (116kb)

Anesthesia Services - PDF (114kb)

Billing Basics - PDF (108kb)

Appendix:

• Appendix 1: Wisconsin Medicaid-Allowable Procedure Codes, Modifiers, TOS Codes, POS Codes, and Rounding Guidelines for CRNA and AA Services - PDF (111kb)
• Appendix 2: HCFA 1500 Claim Form Instructions - PDF (150kb)
• Appendix 3: Completed Sample HCFA 1500 Claim Form - Medically Directed Anesthesia Services (Performed by CRNAs or AAs) - PDF (106kb)
• Appendix 4: Completed Sample HCFA 1500 Claim Form - Medically Supervised Anesthesia Services (Performed by CRNAs Only) - PDF (106kb)
• Appendix 5: Adjustment Request Form Completion Instructions - PDF (20kb)
• Appendix 6: Completed Sample Wisconsin Medicaid Adjustment Request Form - PDF (671kb) | Instructions  - PDF (20kb)
• Appendix 7: Wisconsin Medicaid Adjustment Request Form (for photocopying) - PDF (89kb)
• Appendix 8: Services Not Covered by Wisconsin Medicaid - PDF (79kb)

Glossary - PDF (103kb)

Important Telephone Numbers - PDF (55kb)

Handbook Order Form - PDF (58kb)

Index - PDF (96kb)

Back to the beginning of this handbook