Commonwealth of Massachusetts
Executive Office of Health and Human Services
Division of Medical Assistance
600 Washington Street
Boston, MA  02111
www.state.ma.us/dma	
	MassHealth
	Diagnostic and Surgical Facility Bulletin 6
	April 2001

	TO:	Diagnostic and Surgical Facilities Participating in MassHealth

	FROM:	Wendy E. Warring, Commissioner

	RE:	HCFA Common Procedure Coding System (HCPCS) Update

Introduction	The federal government has revised the HCFA Common Procedure 
	Coding System (HCPCS) for MassHealth billing.

	The purpose of this bulletin is to inform freestanding magnetic resonance imaging (MRI) centers that the Division will cover the service codes listed 
	later in this bulletin for dates of service provided on or after May 1, 2001.  Descriptions for these service codes must be obtained using the American Medical Association’s 2001 Current Procedural Terminology (CPT) manual.

Payment	These covered services are in addition to those listed in the Diagnostic 
	and Surgical Facility Bulletin 5, issued in August 2000.  In accordance with Division regulations, payments are subject to the terms and conditions of 130 CMR 433.000 and 450.000.

Payment		Payment for these new codes will be determined through individual 
Requirements 		consideration (I.C.) until the Division of Health Care Finance and Policy establishes specific rates and these rates are incorporated into the 
		appropriate regulation.  All claims using the service codes listed in this 
		bulletin must be submitted on paper with a report. The Division will deny 
		any claims submitted electronically.

	

Payment	A radiology report with the radiologist interpretation must accompany 
Requirements	the claim for procedures designated for individual consideration.
(cont.)	The Division will determine the appropriate payment based on the 
	documentation that is submitted to support the use of the service code.
	If the documentation is illegible or incomplete, or if no report is submitted, 
	the Division will deny the claim with the applicable error code.

Questions	If you have any questions, please contact the MassHealth Provider Services Department at (617) 628-4141 or 1-800-325-5231.

2001 MassHealth Service Code Additions

The following service codes are covered under individual consideration until the Division of Health Care Finance and Policy establishes specific rates and these rates are incorporated into the appropriate regulation.  Refer to the 2001 American Medical Association’s Current Procedural Terminology manual for service code descriptions.

70542	70548	73222	74182	
70543	70549	73223	74183	
70544	72195	73718	76393	
70545	72197	73719		
70546	73218	73722		
70547	73219	73723