Health and Recovery Services Administration, Department of Social and Health Services

 
Resource Links


Billing Instructions
Numbered Memoranda
Document Corrections
Fee Schedules
DASA Website

Related Memoranda

09-30
08-32
07-78
07-67
07-33
06-72
05-103
05-89
05-71
05-42
05-25
 
Forms

 

  1. Prior Authorization Request/ Oral Enteral Nutrition Worksheet [DSHS 13-743]

  2. Justification for use of B9998 Miscellaneous Enteral Nutrition Procedure Code  and Limitation Extension Request form [DSHS 13-745]

  3. Justification for use of B9998 Miscellaneous Enteral Nutrition Procedure Code  and Limitation Extension Request form [DSHS 13-745]

  4. Fax/Written Request Basic Information [DSHS 13-756]

  5. Expedited Prior Authorization Request/Oral Enteral Nutrition Worksheet [DSHS 13-761]

  6. Exception to Rule (ETR) form [DSHS 13-864]

 

 

 

 

 

 

 

 

 

 

Enteral Nutrition Billing Instructions

 


ProviderOne Edition Coming Soon

 

 

Current Billing Instructions
(Use for dates of service on and after July 1, 2009)

 

How Much Does DSHS Pay for Enteral Nutrition?

 

 

Where Can I Find Previous Versions of the Billing Instructions?
Click on one of the following dates of service:

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Page modified: November 2009       

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