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Changes to Treatment Authorization Requests

September 5, 2014

Effective September 22, 2014, an ICD code and an ICD indicator are required on electronic Treatment Authorization Request (eTAR) forms.

Effective September 22, 2014, ICD codes are required on paper Treatment Authorization Request (TAR) forms.

Effective September 22, 2014, the use of a description in lieu of an ICD diagnosis code will no longer be accepted.

eTAR Application: Medical
Providers are required to select ICD indicator “ICD-9” in the ICD-CM Type field in the service information section. Providers also are required to enter a valid ICD code in the ICD Code (Decimal Required) field. The Diagnosis Description field will be disabled for data entry.

eTAR Application: Medical

eTAR Application: Pharmacy
Providers are required to select ICD indicator “ICD-9” in the ICD-CM Type field in the service information section. A valid ICD code in the Diagnosis Code (ICD-Code) (Decimal Required) field is already required.

eTAR Application: Pharmacy

Paper TARs: 18-1, 18-2, 18-3, 20-1, 50-1, 50-2 and 50-3
Providers will be required to enter valid ICD codes on paper TAR forms as appropriate. A diagnosis description entry in the Diagnosis Description field without a valid ICD code will no longer be accepted. Paper TARs submitted with only the diagnosis description will be returned.