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ICD-10-CM Diagnosis Code Required on Treatment Authorization Requests

October 05, 2015

Effective October 1, 2015, all Treatment Authorization Request (TAR) forms, electronic or paper, must be submitted using an ICD-10-CM diagnosis code.

  • For electronic TARs (eTARs), both the ICD indicator and the ICD-10-CM diagnosis code will be required.
  • For paper TAR forms (18-1, 18-2, 18-3, 20-1, 50-1, 50-2, 50-3 and 55-1), only the ICD-10-CM diagnosis code will be required. The ICD-10-CM diagnosis code must be entered in the existing diagnosis code field which may be labeled with “ICD-9.”

TARs with an ICD-9-CM diagnosis code that are approved before October 1, 2015, will remain valid for claim submission after October 1, 2015; therefore, a new TAR is not required. Medi-Cal will not accept ICD-10-CM diagnosis codes prior to October 1, 2015.