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HIPAA Compliant Codes
Crosswalk from Medicaid Local Codes to HIPAA Compliant Codes and Modifiers for Specified Providers for Physicians, APNS, Clinics, Limited Practitioners, Excluding Injection and DME Codes.
HIPAA Compliant Codes

The following documents are a guide to providers to indicate the new HIPAA compliant codes when the local level codes are discontinued as well as indicate other code set to be used under HIPAA. In the documents, the effective date for each of the new codes is specifically indicated. Please see the rule number that is indicated for each code for more details.

Related Medicaid Handbook Transmittal Letters


The following Medicaid Handbook Transmittal Letters (MHTLs) address HIPAA Changes for physicians and advanced practice nurses (APNS).

Advanced Practice Nurses

  • MHTL 3355-02-05: APN Handbook Update - Policy/Code Changes Relating to HIPAA -Obstetrical Services 
  • MHTL 3355-02-04: APN Handbook Update - Policy/Code Changes Policy Update: HCPCS and HIPAA Code Changes - Electronic Distribution of Handbook Updates

Physicians

  • MHTL 3336-02-05: Physician Handbook Update- Policy/Code Changes Relating to HIPAA - Obstetrical Services 
  • MHTL: 3336-02-04: Physician Handbook Update - Policy/Code Changes CPCS and HIPAA Code Changes, Electronic Distribution of Handbook Updates