WI · guidance
Wis. ForwardHealth Online Handbook, Hospice, Topic #4837
HIPAA-Compliant Data Requirements
Procedure Codes
All fields submitted on paper and electronic claims are edited to ensure HIPAA (Health Insurance Portability and Accountability
Act of 1996) compliance before being processed. Compliant code sets include CPT (Current Procedural Terminology) and
HCPCS (Healthcare Common Procedure Coding System) procedure codes entered into all fields, including those fields that are
Not Required or Optional.
If the information in all fields is not valid and recognized by ForwardHealth, the claim will be denied.
Provider Numbers
For health care providers, NPIs (National Provider Identifiers) are required in all provider number fields on paper claims and 837
(837 Health Care Claim) transactions, including rendering, billing, referring, prescribing, attending, and Other provider fields.
Non-healthcare providers, including personal care providers, SMV (specialized medical vehicle) providers, blood banks, and
CCOs (community care organizations) should enter valid provider numbers into fields that require a provider number.
Provenance
- Source
- www.forwardhealth.wi.gov
- Retrieved
- 2026-10-02
- Edition
- forwardhealth-hospice-2026-10-01
- Content hash
0670ebd36bda90c497a96e92db7890cc21660d4a51e66736da8780002482095a
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