MedicaidBilling CodesMedium impact
Billing Instructions for Outpatient Stem Cell Transplant Claims
Illinois Medicaid - HFS·IL · Transplant Surgery, Hematology, Oncology·Provider Notice
Effective date
Jul 3, 2003
We identified it
Jun 21, 2026
Summary
New billing instructions for outpatient stem cell transplant claims require hospitals to mark non-covered days when patients receive unrelated services during the transplant period and bill those services separately.
Action Required
Billing team must update procedures for outpatient stem cell transplant claims: use type of bill '131', report non-covered days in FL 8 when unrelated services occur during transplant period, use occurrence span code 74 for non-related service dates, exclude charges and procedure codes for non-covered services from transplant claim, and bill unrelated services separately.