Wyoming Administrative Code
Agency 044 - Insurance Dept
Sub-Agency 0002 - General Agency, Board or Commission Rules
Chapter 51 - UNIFORM HEALTH CLAIM FORMS REGULATION
Section 51-5 - Requirements for Use of HCFA Form 1450

Universal Citation: WY Code of Rules 51-5

Current through September 21, 2024

(a) Institutional care practitioners shall use the HCFA Form 1450 and instructions provided by HCFA for use of the HCFA Form 1450 when filing claims with issuers for health care services. Institutional care providers that bill patients directly shall provide a properly completed HCFA Form 1450 in addition to any other explanatory information used to bill the patient when requested by the patient.

(b) Issuers may only require institutional care practitioners to use the following coding system for the initial filing of claims for health care services:

(i) ICD--CM Codes;

(ii) Revenue Codes;

(iii) HCPCS Codes; and

(iv) The information outlined in Section 5 of this regulation if the charges include direct services furnished by a health care practitioner and the direct services are not covered by the instructions for the HCFA form 1450.

(c) Hospitals may use the HCFA Form 1500 to supplement a HCFA Form 1450 if necessary in billing patients or their representatives or filing claims with issuers for outpatient services.

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