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Implementation of Diagnosis Requirements for Durable Medical Equipment Claims pdf
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Jan 1, 2020
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid now requires ICD-10 diagnosis codes from the prescribing provider's written order to be included in the header of all durable medical equipment (DME) claims. Claims submitted without diagnosis codes will be automatically denied with EOB code 258.
Action Required
For Connecticut Medicaid DME claims: Billing team must ensure all prescriptions include ICD-10 diagnosis codes before submitting claims. Contact prescribing providers to obtain new prescriptions with ICD-10 codes if missing. Update web claim submission process to enter ICD-10 diagnosis code in Principal diagnosis field. Claims without diagnosis codes will be denied with EOB code 258, and claims with diagnosis codes that don't match the written prescription will be subject to recoupment during post-payment audits.