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
Nurse Practitioner Bulletin 10 April 2001
TO:   Nurse Practitioners 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 providers 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 the list of covered services located in Subchapter 6 of your provider manual. In accordance with Division regulations, payments are subject to the terms and conditions of 130 CMR 433.000 and 450.000.

Payment Requirements

Payment for these new codes will be determined through individual 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 because payment is determined from the nurse practitioner’s descriptive report. If the documentation is illegible or incomplete, or if no report is submitted, the Division will deny the claim with the applicable error code.

MassHealth
Nurse Practitioner Bulletin 10
April 2001
Page 2

Payment
Requirements
(cont.)

A report must accompany the nurse practitioner’s claim for procedures designated for individual consideration. This report must be submitted in its entirety and must identify all procedures performed, including technical procedures, the name of the member, the date of the procedures, the diagnosis, and the name of the nurse practitioner.

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

MassHealth
Nurse Practitioner Bulletin 10
April 2001
Page 3
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.

00537	33141	43256	52345	66982	72197	76393	
00550	34800	44370	52346	67221	73206	76819	
00563	34802	44379	52351	69714	73218	90740	
00566	34804	44383	52352	69715	73219	90743*	
01215	34808	44397	52353	69717	73222	92586	
01951	34812	45327	52354	69718	73223	93318	
01952	34813	45341	52355	70496	73706	93662	
01953	34820	45342	52400	70498	73718	97532	
15342	34825	45345	54512	70542	73719	97533	
15343	34826	45387	54522	70543	73722		
16036	34830	47379	55873	70544	73723		
19102	34831	50545	57022	70545	74175		
19103	34832	50947	57023	70546	74182		
19295	35600	50948	57287	70547	74183		
21199	36870	50949	58353	70548	75635		
22520	43231	52341	61697	70549	75952		
22521	43232	52342	61698	71275	75953		
22522	43240	52343	62252	72191	76012		
30465	43242	52344	64614	72195	76013		
For adult members only (aged 19 or older)