MedicaidBilling CodesMedium impact
Update to Expensive Drugs or Devices Provided in an Outpatient Setting
Illinois Medicaid - HFS·IL · Cardiology, Cardiothoracic Surgery, Gastroenterology +1 more·Provider Notice
Effective date
Apr 1, 2004
We identified it
Jun 21, 2026
Summary
Illinois Medicaid is eliminating local 'W' codes for pacemakers/defibrillators and replacing them with HCPCS codes for HIPAA compliance. Prior approval for Remicade (J3490) has been removed, and several device codes are being updated or added.
Action Required
By April 1, 2004: Billing team must update systems to stop using W codes (W7274, W7275) for pacemakers and defibrillators and replace with appropriate HCPCS codes. Update device code E0751 to E0756. Add new device code E0786 for implantable programmable infusion pump replacements. Remove prior authorization requirements for Remicade (J3490) effective January 1, 2004.