| 2011 CPT & HCPCS Codes |
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| Recommendations of the HOSC |
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Updated 1/20/11
Placement recommendations for new procedures codes from 12-09-2010 HOSC meeting (pdf)
This document was updated on 1/20/2011, as some codes were inadvertently omitted. They are highlighted in yellow on the new document.
HIPAA dictates that the OHP contracted managed care plans and the Division of Medical Assistance Programs (DMAP) accept claims for payment from providers that include new procedure codes beginning on January 1st of each year. After consulting with the OHP Contractors and DMAP beginning in 2007 the HSC began reviewing the new procedure codes during meetings in December and January to result in changes to the list that officially goes into effect on April 1st.
In order to help guide DMAP and the contracted plans as they enter the new codes into their systems for HIPAA compliance, the PDF file above indicates the recommendations developed by the Health Outcomes Subcommittee (HOSC) at their December 9th meeting for all of the new 2011 CPT and HCPCS codes. These recommendations include the proposed placement of new codes onto the Prioritized List as well as recommendations to DMAP to designate codes not being placed on the list as exempt, diagnostic, ancillary, or excluded. The recommendations of the HOSC on these new codes, along with some additional technical corrections yet to be reviewed, will then be taken to the full Commission on the afternoon of January 13th for discussion and approval.
Should any changes approved by the full HSC differ from the recommendations of the HOSC, those differences will be noted on this webpage no later than January 20th. An official notification letter detailing all of the final list changes for April 1, 2011 will be sent to the plans in February and forwarded to the DHS Actuarial Services Unit for a determination of any potential financial impact.
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