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HIPAA Implementation Status Update and Contingency Plan Information

Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Oct 16, 2003
We identified it
Jun 21, 2026
Days to comply

Summary

Illinois Medicaid requires hospital outpatient and ambulatory surgical treatment centers to submit both HCPCS/CPT codes AND ICD-9-CM procedure codes on claims starting October 16, 2003. Reimbursement will continue to be based on the highest ICD-9-CM procedure code billed.

Action Required

Action needed
By October 16, 2003: Billing team must update claim submission to include both HCPCS/CPT procedure codes AND ICD-9-CM procedure codes for all hospital outpatient and ASTC services. Configure billing system to require both code sets on claims. Continue using current IDPA formats until successful HIPAA testing is completed.