Learn more on DMAP's EDI 5010 page.


Learn how to apply for Medicaid Electronic Health Record incentives:

Attend a free Webinar

Review resources and frequently asked questions

Are you ready for ICD-10?

Learn the steps to ICD-10 readiness

Visit the CMS Web site for more information

See also:

Medical-Surgical rulebook history

Ancillary Services Criteria

Pharmaceutical Services clinical information

Tools for providers

 

DMAP administrative rules and other information for:

Medical-Surgical services program

Receive Medical-Surgical services program updates by e-mail

Rulebook

January 1, 2012 (pdf) (Current administrative rules. See below for archived rules.)

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Supplemental information

Medical-Surgical Supplemental Information (pdf) - Updated 9/27/11 - Includes information about where to find codes; prior authorization; pharmaceutical references; primary case management services; blood lead screening and risk assessment; hysterectomy and sterilization consent; billing instructions and forms; maternity case management forms; fluoride charts.

Hysterectomy and Sterilization Procedures Manual (pdf) - For all providers who bill for hysterectomies and sterilizations; provides information and tips not found in the administrative rules.

National Drug Code (NDC) Billing Tips (pdf) - This document explains how to enter NDC information on medical and institutional claims for physician-administered drugs). Also see DMAP's frequently asked questions about NDC requirements (link).

Forms

EDMS Coversheet (pdf) - Use this form whenever you fax documentation for prior authorization requests, provider enrollment requests, or hysterectomy/sterilization consent forms to DMAP.

DHS Prior Authorization Request Form - Use this form to submit faxed PA requests to DMAP. Click here for instructions. You can also submit the same information using the Provider Web Portal. Read the handbook or view the tutorial for more information about submitting PA requests on the Web.

Oregon Pharmacy and Oral Nutritional Supplement PA Request (pdf) - When requesting prior authorization for drugs or oral nutritional supplements dispensed to OHP clients on a fee-for-service basis, fax this form to the Oregon Pharmacy Call Center at 888-346-0178.

Hysterectomy Consent Form - English or Spanish

Consent to Sterilization Form (age 21 or over) - English or Spanish

Consent to Sterilization Form (ages 15 through 20) - English or Spanish

Maternity Case Management Forms - Initial Assessment, Training and Education Tracking, Home and Environmental Assessment, FAIR for Smoking Cessation

Lead Risk Assessment Questionnaire

Who to call for help

Provider Services 800-336-6016 or e-mail us
Address and telephone contacts