MedicaidAdministrativeMedium impact
Attachment C Utilization Review Changes
Illinois Medicaid - HFS·IL · Vascular Surgery, Cardiology, Hematology +1 more·Provider Notice
Effective date
Jan 1, 2010
We identified it
Jun 21, 2026
Summary
Changes to ICD-9-CM diagnosis codes subject to mandatory concurrent utilization review for inpatient admissions. Multiple new chronic and acute venous embolism/thrombosis codes are being added to Attachment C requiring mandatory review, while some existing codes are being deleted or revised.
Action Required
By January 1, 2010: Billing team must update utilization review processes to include mandatory concurrent review for new chronic venous embolism diagnosis codes (453.50-453.79). Ensure staff are aware that acute venous embolism codes (453.81-453.89) automatically became reviewable on October 1, 2009. Update any internal coding references to remove deleted code 453.8 and use the new 5-digit extensions instead. Contact HealthSystems of Illinois at 1-800-418-4045 for questions about the review process.