Text Size:   A+ A- A   •   Text Only
Site Image

Past Prioritized List
April 1, 2009
Updated 07/30/10
April 1, 2009 Prioritized List of Health Services (pdf) 
Extracted Mental Health and Chemical Dependency Lines (pdf) 
Errata for April 1, 2009 Prioritized List of Health Services (pdf) Updated 7-21-10
Recommendations on the placement of new procedures codes from 12-04-08 HOSC meeting (pdf)
*** Changes to files posted on 3/20/09, updated 3/31/09 (pdf) ***
The 2008-09 Prioritized List of Health Services’ newest set of modifications go into effect April 1, 2009. The new list is based on the one appearing in the Health Services Commission's June 2007 Report to the Governor and 74th Oregon Legislative Assembly, and reflects all interim modifications included in the notification letters to legislative leadership dated September 6, 2007 through March 11, 2009. This list has a funding level that covers services appearing on lines numbered 1 - 503 out of the 680 lines. For your convenience, the corresponding Condition Index (pdf) and Treatment Index (pdf) by key word may be accessed by clicking on the desired link.

An ICD-9-CM code (pdf) file and a CPT-4/HCPCS code (pdf) file are available to view the placement of individual codes on the April 1, 2009 List. Click on the desired link to view a searchable PDF file sorted by code. Note that the ICD-9-CM file includes all codes appearing on the List in addition to any valid fourth- or fifth-digit codes that are subsumed within those codes. For example, the three-digit code 860 appears on line 154 of the Prioritized List and this file will include codes 860, 860.0, 860.1, 860.2, 860.3, 860.4, and 860.5. In this way the inclusion of 860 indicates that all valid fourth-digit codes are present on the line (i.e., 860.6-860.9 are not valid codes and therefore are not included) even though 860 itself is not a billable code.

The CPT-4/HCPCS file includes both medical and surgical CPT-4 codes and all HCPCS codes appearing on the list. All codes are listed individually, including the standard set of medical therapy codes that were previously represented as “99xxx”.

The ICD-9-CM code list is only included here for assistance to those who wish to search the list by diagnosis code. Please refer to the April 1, 2009 Prioritized List of Health Services (pdf) for the official definition of each line item by ICD-9-CM. If any discrepancies are found between either the ICD-9-CM or CPT-4/HCPCS files and the PDF file of the complete list, please email to report them to us.

Also available are an ICD-9-CM code without decimal (txt) file, ICD-9-CM code with decimal (txt) file, and CPT-4/HCPCS code (txt) file. These files are in a tab-delimited text file format for downloading and contain the same information as described above. A previous file that individually listed each medical therapy code represented by “99xxx” in prior versions of the CPT-4/HCPCS code text file is no longer necessary since this latter file now contains all procedure codes appearing on each line. For those needing a list of these medical therapy codes and the lines they appear on for this list, you may click here for a PDF file with this information.  This file is included here for transitioning purposes and such a file will not be posted in the future as the new, all-inclusive procedure code file now available should meet the needs of everyone using these files.  A fourth text file, providing the condition and treatment descriptions (txt) for each line item, is also available.  Please click here for a document that lists a set of nine changes made to one or more of the files that appeared on the ‘Pending Change to List’ webpage from 3/20/09 to 3/31/09.

Interim Modifications to Prioritized List Effective April 1, 2009 (pdf)
*** Errata to 3/11/09 Notification Letter (pdf) ***
This notice to the Senate President dated March 11, 2009, identifies the sixth set of interim modifications made to the 2008-09 Prioritized List of Health Services appearing in Appendix C of the Commission's June 2007 Biennial Report. These interim modifications go into effect on April 1, 2009.

Effective October 1, 2007, the lines titled ‘Comfort Care’ and ‘Medical Conditions Where Treatment of the Condition Will Not Result in a 5% 5-Year Survival’ were deleted from the Prioritized List and replaced with a statement of intent to clarify what end-of-life care services the Commission intended for coverage. In deleting the latter line (line 674 on the 2006-07 list and what would have been line 613 on the 2008-09 list) it was discovered that some ICD-9-CM codes did not appear elsewhere on the list. Since this resulting omission was unintentional, some codes for some advanced cancers were reinstated in a new version of line 613 effective since October 1, 2008. What would be line 71 on the current (line 262 on the 2006-07 list) remains deleted.