Commonwealth of Massachusetts 
Executive Office of Health and Human Services 
Office of Medicaid 
600 Washington Street
Boston, MA  02111 
www.mass.gov/masshealth

 MassHealth 
 Acute Outpatient Hospital Bulletin 12
 January 2005
     TO:       Acute Outpatient Hospitals and Hospital-Licensed Health Centers Participating in
                  MassHealth
FROM:       Beth Waldman, Medicaid Director 

RE:       2005 Healthcare Common procedure Coding System (HCPCS) Coding Update

Introduction	The federal government has revised the Healthcare Common Procedure Coding System (HCPCS) for MassHealth billing. 
For dates of service on or after January 1, 2005, service codes discontinued by the Centers for Medicare and Medicaid Services (CMS) and deleted by the American Medical Association Current Procedural Terminology (CPT) for 2005 will no longer be payable by MassHealth.  Services described by these codes may be billed with replacement codes.  Replacement codes are Level 1 HCPCS codes from any year, including 2005, that replace the 2005 “deleted” codes.  MassHealth will pay only for new 2005 HCPCS code additions that are replacing the 2005 deleted codes. 
MassHealth will not be adopting any other 2005 HCPCS code additions at this time. MassHealth will be reviewing the remainder of the 2005 HCPCS code additions and changes and will determine coverage policies and other requirements at a later date.  Providers will receive a transmittal letter and updated version of Subchapter 6 for their provider manual when the final review of 2005 HCPCS code additions is complete. 
The 2005 deleted codes and HCPCS additions that are payable for dates of service on or after January 1, 2005, are attached to this bulletin.

Payment 	
The 2005 HCPCS code additions attached to this bulletin are payable services in addition to the services described in Subchapter 6 of your provider manual.  In accordance with MassHealth regulations, payments are subject to the terms and conditions of 130 CMR 410.000 and 450.000. 	
Questions 	If you have any questions, please contact MassHealth Provider Services at 
617-628-4141 or 1-800-5231. 	

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MassHealth Acute Outpatient Hospital Bulletin 12 January 2005 Attachment 
Updates to MassHealth’s List of Payable Codes for Acute Outpatient Hospitals 
Listed below are the service codes that replace HCPCS codes that have been deleted in 2005 and are payable by MassHealth for dates of service on or after January 1, 2005.  Providers should refer to www.cms.hhs.gov for service descriptions. 
52402 				88187 
78811 				88188 
78812 				88189 
78813 				91034 
79005 				91035 
79101 				91037 
79445 				91038 
88184 				92620 
88185 				92621 
Discontinued Service Codes for Acute Outpatient Hospitals 
The following codes are deleted for 2005 and are no longer payable by MassHealth for dates of service on or after January 1, 2005. Providers should refer to www.cms.hhs.gov for service descriptions. 
35161 				79020 
35162 				79030 
35582 				79035 
50559 				79100 
50578 				79400 
50959 				79420 
50978 				79900 
52347 				88180 
78810 				91032
78990 				91033 
79000 				92589 
79001