MedicaidDocumentationMedium impact
Temporary Suspension of Diagnosis Code Requirement for Opioid Medication Claims pdf
Connecticut Medicaid (HUSKY Health)·CT · Pain Management, Family Medicine, Internal Medicine +1 more·Pharmacy
Effective date
Oct 18, 2019
We identified it
Jun 20, 2026
Summary
The Department of Social Services has temporarily suspended the diagnosis code requirement for opioid medication prescriptions until December 16, 2019. During this 60-day grace period, pharmacy claims for opioid medications will not be denied for missing ICD-10 diagnosis codes, but the requirement will be reinstated after the suspension ends.
Action Required
By December 16, 2019: Providers must update EMR systems to include valid ICD-10 diagnosis codes for all opioid prescriptions. Billing team should remind prescribers that opioid claims without supporting diagnosis codes will begin denying again after the grace period ends. Update encounter forms and EMR templates to require diagnosis code documentation for opioid medications.