MedicaidAdministrativeMedium impact
Use of Condition Code DR for Institutional Claims – COVID-19
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
May 22, 2020
We identified it
Jun 20, 2026
Summary
Illinois institutional providers must add Condition Code DR (Disaster Related) to all claims containing specific COVID-19 related diagnosis codes for tracking purposes. This applies to services dating back to January 27, 2020 for fee-for-service and managed care programs.
Action Required
Immediately: Billing team must update institutional claim submissions to include Condition Code DR when any of the specified COVID-19 diagnosis codes (B97.29, U07.1, Z03.818, Z11.59, Z20.828) are present. Apply retroactively to all services from January 27, 2020 forward. Update billing system rules to automatically flag these claims for proper condition code assignment.