MedicaidAdministrativeMedium impact
Attachments B and C Utilization Review Update for November 1, 2008
Illinois Medicaid - HFS·IL · Endocrinology, Infectious Disease, Wound Care +4 more·Provider Notice
Effective date
Nov 1, 2008
We identified it
Jun 21, 2026
Summary
Illinois Medicaid has updated their utilization review requirements, adding new ICD-9 codes that trigger mandatory concurrent review for inpatient admissions. This includes diabetes complications, pressure ulcers with staging, and delirium diagnoses.
Action Required
Before November 1, 2008: Clinical staff must initiate mandatory concurrent utilization review for all inpatient admissions with the newly added ICD-9 codes. Update admission protocols and utilization review checklists to include these codes. Contact HealthSystems of Illinois (HSI) at 1-800-418-4045 for review process questions.