Section 8-9 - Hospital Responsibilities A hospital which seeks Medicaid payment for inpatient hospital service provided to a client shall:
(a) Obtain an admission certification pursuant to this Chapter, if required.
(b) Request a written admission form to provide certification by contacting the Department in writing as required by the Department and provide the following information: - (i) The attending physicians name and National Provider Identifier (NPI) number;
- (ii) The clients name, Medicaid identification number and date of birth;
- (iii) The name of the hospital;
- (iv) The principal diagnosis by narrative description or diagnostic code according to the International Classification of Disease (ICD), as specified by the Department;
- (v) The primary procedure by narrative description or procedure code according to the Current Procedural Terminology (CPT), as specified by the Department;
- (vi) Whether the admission is a readmission;
- (vii) The expected date of admission; and
- (viii) Information from the plan of care and information concerning the reason for admission as requested by the Department to determine if admission meets the medical necessity criteria.
(c) Provide the following information when applicable: - (i) Surgeons name and NPI number;
- (ii) Expected date of surgery; and
- (iii) Affirmation that any required prior authorization has been received.
(d) Enter the admission certification and any required prior authorization number on all claims submitted to the Department.