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Use of ICD 9 Codes
Effective October 22, 2018, HCHCP is initiating a 4 month long “soft launch” rule change that will no longer allow ICD 9 codes to be used for prior authorization requests. During the soft launch timeframe, please change any ICD 9 codes to ICD 10 when submitting your requests to KEPRO. Beginning February 18, 2019, the system will no longer allow ICD 9 codes and will stop your review from being submitted until an ICD 10 code is utilized. HCHCP network providers are strongly encouraged to only use ICD 10 codes for all request submissions. A notification will be posted on February 18, 2019 when the supporting rule to block ICD 9 codes is implemented.
Posted: 10/23/2018
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Keystone Peer Review Organization, Inc. (KEPRO), an industry leader in providing
innovative, value-added healthcare management solutions, has been awarded the "Medical
Management and Services" contract through Hillsborough County's Health and Social
Services. The Hillsborough County (HCHCP) contract ensures appropriate, quality-driven
care through quality improvement of specified inpatient hospital, medical and surgical
services.
Recognized as the largest federally designated Quality Improvement Organization
(QIO) in the nation, KEPRO's reputation is a result of providing many years of innovative
healthcare management solutions to multiple state Medicaid and Medicare programs,
the Department of Defense's (DoD) national TRICARE program, and 5 of the nation's
largest insurance providers.
The Internet based system uses InterQual criteria to safeguard against unnecessary
or inappropriate use of Medicaid services and provides clients with an enhanced
secure system to perform accurate, confidential medical record review through a
remote-user, virtual private network.
KEPRO is URAC accredited in Health Utilization Management and Case Management. We
are also licensed to perform medical reviews in 29 states.