Commonwealth of Massachusetts
Executive Office of Health and Human Services
Division of Medical Assistance
600 Washington Street Boston, MA 02111
MASSHEALTH
TRANSMITTAL LETTER CRP-19
August 2003

TO:      Chiropractors Participating in MassHealth FROM:      Douglas S. Brown, Acting Commissioner

RE:

Chiropractor Manual (Changes to Service Codes and Descriptions)

This letter transmits revisions to the list of MassHealth-covered codes and descriptions in Subchapter 6 of the Chiropractor Manual. These revisions are effective for dates of services on or after July 1, 2003.
2003 HCPCS (Healthcare Common Procedure Coding System) codes have been added to replace certain MassHealth local codes. The local codes have been replaced so that the Division’s coding requirements are compliant with HIPAA (the Health Insurance Portability and Accountability Act of 1996).
Effective for dates of service beginning August 15, 2003, the Massachusetts local code for office visit for the evaluation and management of a new patient (X1616) will be replaced by CPT code 99201, and the Massachusetts local code for office visit for the evaluation and management of an established patient (X1617) will be replaced by CPT code 99212. For dates of service between July 1, 2003, and August 14, 2003, providers may use either the Massachusetts local code or the CPT code.
A crosswalk table, listing the old service codes and descriptions and the new HIPAA-compliant ones, is attached.
How to Obtain a Chiropractor Fee Schedule
Providers who want to obtain a fee schedule may purchase Division of Health Care Finance and Policy regulations from either the Massachusetts State Bookstore or from the Division of Health Care Finance and Policy (see addresses and telephone numbers below). Providers must contact them first to find out the price of the publication. The Division of Health Care Finance and Policy also has the regulations available on disk. The regulation title for evaluation and management services and chiropractic manipulative treatment services is 114.3 CMR 28.00: Chiropractic Services. The regulation title for radiology services is 114.3 CMR 18.00: Radiology.

Massachusetts State Bookstore State House, Room 116 Boston, MA 02133 Telephone: 617-727-2834 www.mass.gov/sec/spr

Division of Health Care Finance and Policy Two Boylston Street Boston, MA 02116 Telephone: 617-988-3100 www.mass.gov/dhcfp

MASSHEALTH
TRANSMITTAL LETTER CRP-19 August 2003 Page 2
DMA Web Site
This transmittal letter and attached pages are available on the Division’s Web site at www.mass.gov/dma.
Questions
If you have any questions about this transmittal letter, please contact MassHealth Provider Services at 617-628-4141 or 1-800-325-5231.
NEW AND REVISED MATERIAL (The pages listed here contain new or revised language.)
Chiropractor Manual
Pages 6-1 and 6-2
OBSOLETE MATERIAL (The pages listed here are no longer in effect.)
Chiropractor Manual
Pages 6-1and 6-2 — transmitted by Transmittal Letter CRP-15

Chiropractor Service Code Crosswalk

Old                     Description                     New                     Description	
Code                                                          Code	
X1616	Office visit for the evaluation and	99201	Office or other outpatient	
	management of a new patient,		visit for the evaluation and	
	requiring the following three key		management of a new	
	components:		patient, which requires these	
	• a problem-focused history;		three key components:	
	• a problem-focused examination;		• a problem-focused history;	
	and		• a problem-focused examination;	
	• straightforward medical		and	
	decision-making		• straightforward medical decision-making.	
X1617	Office visit for the evaluation and	99212	Office or other outpatient visit for	
	management of an established		the evaluation and management of	
	patient, requiring the following		an established patient, which	
	three key components:		requires at least two of these three	
	• a problem-focused history;		key components:	
	• a problem-focused examination;		• a problem-focused history;	
	and		• a problem-focused examination;	
	• straightforward medical		and	
	decision-making.		• straightforward medical decision-making.	

Commonwealth of Massachusetts
Medical Assistance Program
Provider Manual Series
CHIROPRACTOR MANUAL	SUBCHAPTER NUMBER AND TITLE
6 SERVICE CODES AND DESCRIPTIONS	PAGE
6-1	

	TRANSMITTAL LETTER
CRP-15	DATE
09/01/97	
601 CHIROPRACTOR SERVICES: SERVICE CODES AND DESCRIPTIONS
Service
Code       Service Description
EVALUATION AND MANAGEMENT SERVICES
X1616     Office visit for the evaluation and management of a new patient, requiring the following three key components:
 •	a problem-focused history;
 •	a problem-focused examination; and
 •	straightforward medical decision making.
X1617     Office visit for the evaluation and management of an established patient, requiring the following three key components:
 •	a problem-focused history;
 •	a problem-focused examination; and
 •	straightforward medical decision making.
CHIROPRACTIC MANIPULATIVE TREATMENT
98940	Chiropractic manipulation (CMT), spinal; one to two regions
 98941	three to four regions
 98942	five regions
RADIOLOGY SERVICES
72010	Radiologic examination, spine; entire, survey study, anteroposterior and lateral
72020	single view, specify level
72040	cervical, anteroposterior and lateral
72070	thoracic, anteroposterior and lateral
72080	thoracolumbar, anteroposterior and lateral
72100	lumbosacral, anteroposterior and lateral

Commonwealth of Massachusetts
Medical Assistance Program
Provider Manual Series
CHIROPRACTOR MANUAL	SUBCHAPTER NUMBER AND TITLE
6 SERVICE CODES AND DESCRIPTIONS	PAGE
6-2	

	TRANSMITTAL LETTER
CRP-15	DATE
09/01/97	
THIS PAGE IS RESERVED.