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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
Effective January 1, 2020, all Durable Medical Equipment (DME) claims submitted to the Department of Social Services must include ICD-10 diagnosis codes or they will be automatically denied. Claims submitted without diagnosis codes will receive EOB code 258 - Primary Diagnosis Code Missing.
Action Required
Immediately: Billing team must update DME claim submission processes to ensure all MEDS claims include valid ICD-10 diagnosis codes. Update billing software to require diagnosis codes for all DME/MEDS claims before submission. Train staff that claims without diagnosis codes will be denied with EOB code 258.