Illinois presentation 2026

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The document provides an overview of billing procedures and guidelines for family planning services under the Illinois Department of Public Aid, including specific HCPCS codes for various contraceptive methods, requirements for claim submissions, and instructions for using the Medical Electronic Data Interchange (MEDI) system. It outlines the necessary documentation and coding for different family planning services such as birth control pills, IUDs, and abortions, along with contact information for billing inquiries.

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Begin by indicating 'yes' in box 23B for family planning services on the claim form. This is crucial for proper processing.
In the procedure code field, enter the appropriate Evaluation/Management (E/M) HCPCS code and include 'FP' in the modifier field directly after it.
For product information, utilize the description field (24C) to specify details about dispensed drugs, ensuring you stay within the 80-character limit for electronic submissions.
When entering quantities, use field 24F for days/units on the claim form or Loop 2400, element SV103 for electronic formats.
Ensure that all family planning visits are billed with the correct diagnosis code (V25.XX) to avoid any claim rejections.

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