MedicaidAdministrativeMedium impact
Removal of Diagnosis Code Requirements for Opioid Medication Pharmacy Claims pdf
Connecticut Medicaid (HUSKY Health)·CT · Pain Management, Family Medicine, Internal Medicine +4 more·Pharmacy
Effective date
Dec 16, 2019
We identified it
Jun 20, 2026
Summary
The Department of Social Services has permanently suspended the requirement for diagnosis codes on opioid medication pharmacy claims. Pharmacies will no longer need to include ICD-10 diagnosis codes with opioid prescriptions to avoid claim denials.
Action Required
Immediately: Notify pharmacy partners that ICD-10 diagnosis codes are no longer required for opioid medication claims. Update any internal protocols that required diagnosis code documentation for opioid prescriptions. Pharmacies can submit opioid claims without fear of NCPDP Reject code 39 denials.