MedicaidAdministrativeMedium impact
Diagnosis Code Requirement for 5010 837P Electronic Claim Submission
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jan 1, 2012
We identified it
Jun 21, 2026
Summary
Starting January 1, 2012, all transportation claims submitted electronically using the new 5010 837P format must include a diagnosis code. Transportation providers must use ICD-9 diagnosis codes provided by treating physicians, or use code 799.9 for unspecified illness if no diagnosis is available.
Action Required
By January 1, 2012: Transportation providers must update billing systems to require diagnosis codes on all 5010 837P electronic claims. Use ICD-9 codes provided by treating physicians or code 799.9 when no diagnosis is available. Update billing software to validate diagnosis code presence before claim submission.