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Elizabeth M. Whitehorn, Director

Provider Notice issued 09/29/15

Inpatient Detoxification Readmissions – Crosswalk to ICD-10 Diagnosis Codes

 

To:​ Enrolled Hospitals:  Chief Executive Officers, Chief Fiscal Officers, and Patient Accounts Managers       ​
​Date: ​September 29, 2015
​Re: Inpatient Detoxification Readmissions – Crosswalk to ICD-10 Diagnosis Codes​

 

As a result of Public Act 097-0689 (pdf), the department implemented utilization review changes in 2012 specific to inpatient level of care for detoxification readmissions. Inpatient detoxification admission stays are not approved by the department’s quality improvement organization (QIO) for reimbursement if there has been a previous inpatient detoxification stay within the last 60 days.

The original International Classification of Diseases, Ninth Revision (ICD-9-CM) diagnosis code list of detoxification codes identified in the June 30, 2012 Informational Notice has been crosswalked to the ICD-10-CM code set. This crosswalk has prompted an update to utilization review Attachment B.  Utilization Review Attachments A-F are available on the department’s Peer Review Organization (PRO)/Quality Improvement Organization (QIO) webpage. As the majority of codes in Attachment B are subject to the 60-day review of detox admissions, only those not subject to the 60-day review of detox admissions are identified with an asterisk.    

Any questions regarding the review process may be directed to the department’s QIO, eQHealth Solutions Inc., at the toll-free Helpline at 1-800-418-4045. Any questions regarding this notice may be directed to the Bureau of Quality Management at 217-557-5438.

 

  

Felicia F. Norwood

Director