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Provider Notice issued 10/31/05
- 291.82 Alcohol induced sleep disorder
- 292.85 Drug induced sleep disorder
To: Participating Hospitals: Chief Executive Officers, Chief Financial Officers, Patient Accounts Managers, and Utilization Review Departments
Date: October 31, 2005
Re: Utilization Review – Additional Diagnosis Codes Subject to Review
The ICD-9-CM Coordination and Maintenance Committee, a Federal Interdepartmental Committee co-chaired by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), has updated the diagnosis and procedure codes in the ICD-9-CM coding book, effective October 1, 2005. The purpose of this notice is to inform providers about which of the new ICD-9-CM codes will be subject to utilization review. The changes will be effective with admissions occurring on and after December 1, 2005.
The following summarizes the changes that will take effect with admissions on and after December 1, 2005.
Explanation of Changes
The following codes have been added to Attachment B:
The ICD-9-CM coding changes also include a description change for diagnosis code 403.91, which is currently subject to review. Attachment C has been updated to reflect the new description. The detailed description changes are located on HealthSystems of Illinois’ (HSI) Web site at <www.hsofi.org>.
This notice is located on the department’s Web site at: http://www.hfs.illinois.gov/hospitals/
Attachments A, B, C, and D are located on the department’s Web site at:
http://www.hfs.illinois.gov/proqio/
No changes are being made to Attachment A, “Mental Disorders Diagnosis Codes and Descriptions Subject to Certification of Admission/Concurrent/Continued Stay Review” and Attachment D, “DRG Codes Subject to Retrospective Prepayment Review.” Attachments A and D were last revised May 1, 2005. Attachments A and D are located for convenience along with Attachments B and C on the Web site.
To reduce copying and mailing cost, the department may not always include hardcopies of attachments referenced in notices and bulletins. Web site links will be identified so providers may view and print the material from the Internet. Providers wishing to receive e-mail notification, when new provider information has been posted by the department, may register at the following HFS Web site:
http://www.hfs.illinois.gov/provrel
As you may know, the name of the Department of Public Aid (DPA) has changed to Healthcare and Family Services (HFS). We are in the process of updating forms, handbooks, and the Internet with our new name. However, until existing supplies are exhausted, we will continue to use materials bearing the former DPA name and logo. Either version of documents should be considered official regardless of the department name they bear. Only our name has changed. HFS’s programs, staff, office locations, mailing addresses and phone numbers remain the same as DPA’s. We believe our new name more clearly reflects our mission of service to the State of Illinois including providing access to health care for over two million Illinoisans. We deeply appreciate your participation in our programs and we hope this change poses no inconvenience for you.
Any questions regarding this notice may be directed to the Bureau of Maternal and Child Health Promotion at 217-524-7478.
Anne Marie Murphy, Ph.D.
Administrator
Division of Medical Programs