| Health Services Commission Prioritized List of Health Services |
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| October 1, 2007 |
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October 1, 2007 Prioritized List of Health Services (pdf)
Extracted Mental Health and Chemical Dependency Lines (pdf)
The 2005-07 Prioritized List of Health Services appearing in the Health Services Commission’s March 2005 Report to the Governor and 73rd Oregon Legislative Assembly, along with all interim modifications included in the notification letters to legislative leadership dated September 6, 2007, began implementation on October 1, 2007. This list has a funding level that covers services appearing on lines numbered 1 - 530 out of the 710 lines. For your convenience, the corresponding Condition Index (pdf) and Treatment Index (pdf) by key word may be accessed by clicking on the desired index.
An ICD-9-CM code (pdf) and a CPT-4/HCPCS code (pdf) are now available to view the placement of individual codes on the October 1, 2007 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 5 of the Prioritized List and this file will include codes 860, 860.0, 860.1, 860.2, 860.3, 860.4, 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).
The CPT-4/HCPCS file now includes both medical and surgical CPT-4 codes and all HCPCS codes appearing on the list. All codes are listed individually except where the standard set of medical therapy codes appear on a line. This standard set of codes is 99024, 99051, 99060, 99070, 99078, 99201-99362, 99374-99375, 99379-99440 and will be represented in the file as "99xxx". Should any of these codes appear on a line that does not include the full set of medical therapy codes shown above, they will be listed individually.
The code lists are only included here for assistance to those who wish to search the list by code. Please refer to the October 1, 2007 Prioritized List of Health Services (pdf) for the official definition of each line item. If any discrepancies are found please email to report them to us.
Also available are an ICD-9-CM code without decimal (txt), ICD-9-CM code with decimal (txt) and CPT-4/HCPCS code (txt). These files are in a tab-delimited text file format for downloading and contain the same information as describe above. A fourth text file, providing the condition and treatment descriptions (txt) for each line item is also now available.
Interim Modifications to Prioritized List Effective October 1, 2007 (pdf)
This notice to the Senate President dated September 6, 2007 identifies the fifth set of interim modifications made to the 2005-07 Prioritized List of Health Services appearing in Appendix E of the Commission’s March 2005 Biennial Report. These interim modifications went into effect on October 1, 2007.
It should be noted that two entire line items are being deleted from the list as part of this set of interim modifications. DMAP was reporting some ambiguity in the Commission’s intent on the coverage of comfort care services. As a result, the Commission has decided to delete lines 262 (Comfort Care) and 674 (Medical Conditions Where Treatment Will Result in Less Than a 5% Five-Year Survival) and add a statement of intent to clarify the matter.
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