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Hospital Inpatient Admission Orders and Use of Condition Code 44 Effective with Admissions On and After October 1, 2015
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Oct 1, 2015
We identified it
Jun 20, 2026
Summary
Effective October 1, 2015, hospitals must maintain proper inpatient admission orders in medical records with specific language like 'admit to inpatient' and use Condition Code 44 when changing a patient's status from inpatient to outpatient before discharge. All admission orders must be legible, dated, timed, and authenticated before discharge, with no retroactive orders permitted.
Action Required
Immediately: Hospital billing teams must ensure all inpatient admission orders contain specific language such as 'admit to inpatient', 'admit as an inpatient', or 'for inpatient services' and are properly documented, dated, timed, and authenticated before discharge. When changing patient status from inpatient to outpatient before discharge, use Condition Code 44 in FL 18-28, write new outpatient orders, and ensure at least one APL service is included or the claim will pay at zero. Medical records staff must maintain original inpatient orders while documenting the reason for status changes.