MedicaidBilling CodesHigh impact
HIPAA Readiness February 2004 Update
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Apr 1, 2004
We identified it
Jun 21, 2026
Summary
Illinois Medicaid is implementing HIPAA billing format changes with multiple transition dates. Providers must switch from local codes to standard HCPCS codes by April 1, 2004, convert to new APL HCPCS/CPT codes for outpatient procedures by July 1, 2004, and transition drug billing from 8-digit codes to HCPCS codes by April 1, 2004.
Action Required
By April 1, 2004: Billing team must update systems to use standard HCPCS codes and two-byte modifiers instead of state local codes for all services except DME. By July 1, 2004: Convert outpatient UB92/837I transactions to use new APL HCPCS/CPT codes (new APL available June 1, 2004 on department website). Immediately: Stop using 8-digit drug codes for physician-administered drugs and switch to appropriate HCPCS codes. Coordinate with software vendors and clearinghouses for NSF programming changes to accommodate new two-byte modifiers.