Changes in Item 78 Codes - Changes in Item 80 Countable Income Codes - KC Assist and KCMAB

Helping Families. Supporting Communities. Empowering Individuals.

11/10/04

Summary:

  • Beginning 11/24/04, Item 78 codes B, G, I and Q are eliminated. The only valid Item 78 codes for KidCare Assist are R, T, and "-" dash.
  • Beginning 11/24/04, Item 80 Countable Income codes 157, 159, 160 and 163 are eliminated. The only valid Item 80 Countable Income code for KidCare Assist and KidCare Moms and Babies is 158.
  • This is being done to simplify the coding for local office staff and to ensure that more accurate data is sent to MMIS for federal claiming purposes.
  1. CHANGE IN ITEM 78 CODES
  2. CHANGE IN ITEM 80 COUNTABLE INCOME CODES
  3. CENTRAL CONVERSION
  4. INVALID CODING

Public Aid (DPA). DPA administers the Medicaid and KidCare programs. These programs provide medical benefits to families with children and to other persons. This information is to be used by staff of the Illinois Department of Human Services when authorizing medical benefits for persons on behalf of DPA.

CHANGE IN ITEM 78 CODES

Beginning 11/24/04, Item 78 codes B, G, I, and Q are eliminated. The only valid codes for KidCare Assist are R, T, and "-" dash. Codes P, H, N, and 3 are still valid for KidCare Moms and Babies.

  • Code R indicates that income is above the Family Assist standard but equal to or less than 133% of the FPL - child was not previously coded C in Item 78.
  • Code T indicates that income is above the Family Assist standard but equal to or less than 133% of the FPL - child was previously coded C in Item 78.

CHANGE IN ITEM 80 COUNTABLE INCOME CODES

Beginning 11/24/04, Item 80 codes 157, 159, 160, and 163 are eliminated. The only valid countable income code for KidCare Assist and KidCare Moms and Babies is code 158. Code 177 is still valid for KidCare Share, KidCare Premium, and KidCare Rebate cases.

CENTRAL CONVERSION

The night of 11/24/04, the following central action will take place:

  • All Item 78 codes B and Q will be changed to code R;
  • All Item 78 codes G and I will be changed to code T; and
  • All Item 80 codes 157, 159, 160, and 163 will be changed to code 158.

INVALID CODING

Item 78 code S became invalid 10/02. System edits are in place to stop the processing of a case with code S in Item 78.

Item 80 code 158 is required for all Assist, Family Health Spenddown, and KidCare Moms and Babies cases. System edits are in place to stop the processing of a case without code 158.

Invalid or missing codes must be corrected before completing a transaction on a Family Health Plans case.

[signed copy on file]

CAROL L. ADAMS, Ph.D.
Secretary, Illinois Department of Human Services

BARRY S. MARAM
Director, Illinois Department of Public Aid