October 1, 2011 Prioitized List of Health Services (pdf)
Errata for Interim Modification to Prioritized List Effective October 1, 2011
For your convenience, we have extracted out the lines including mental health & chemical services from the full list for those particularly interested in the placement of these condition-treatment pairs and their related guidelines. Extracted Mental Health and Chemical Dependency Lines (pdf).
A new Prioritized List of Health Services will go into effect on October 1, 2011 that incorporates the ICD-9-CM codes for 2012 and makes other technical changes. This list reflects the fourth set of interim modifications made to the 2010-11 that appeared in the Health Services Commission's 2009 Report to the Governor and 75th Oregon Legislative Assembly that went into effect on January 1, 2010. This list has a funding level that covers services appearing on lines numbered 1 - 502 out of the 679 lines.
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, 2011 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 153 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 above 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.”
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 fifth text file, providing the condition and treatment descriptions for each line item, is also available.
For your convenience, the corresponding Condition Index and Treatment Index by key word may be accessed by clicking on the desired link.
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 emailto report them to us.
Interim Modification to Prioritized List Effective October 1, 2011.
This notice to the Senate President dated September 12, 2011, identifies the fourth set of interim modifications made to the 2010-11 Prioritized List of Health Services appearing in Appendix C of the Commission's June 2009 Biennial Report. These interim modifications go into effect on October 1, 2011.
Prioritized List of Health Services effective 4/1/11 - 9/30/11