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Change to Diagnosis Requirements for Durable Medical Equipment Claims pdf
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Oct 1, 2019
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid now requires ICD-10 diagnosis codes on all Durable Medical Equipment (DME) claims effective October 1, 2019. The diagnosis code must match what's written on the prescription/written order from the prescribing practitioner, and claims without diagnosis codes will receive EOB code 258.
Action Required
By October 1, 2019: Billing team must ensure all Connecticut Medicaid DME claims include ICD-10 diagnosis codes in the Principal diagnosis field on web claim submissions. Contact prescribing practitioners to obtain new prescriptions with ICD-10 codes if current prescriptions lack them. Update claim submission workflow to verify diagnosis codes match prescription documentation before submitting. Claims without diagnosis codes will receive EOB code 258 and may face future denials.