### Addendum M.-Proposed HCPCS Codes for Assignment to Composite APCs for CY

2012

### HCPCS Code Short Descriptor CI SI Single Code APC Assignment Composite APC

Assignment

### 90801 Psy dx

interview Q3 0323 0034

### 90802 Intac psy dx

interview Q3 0323 0034

### 90804 Psytx office 20-30

min Q3 0322 0034

### 90805 Psytx off 20-30 min

w/e&m Q3 0322 0034

### 90806 Psytx off 45-50

min Q3 0323 0034

### 90807 Psytx off 45-50 min

w/e&m Q3 0323 0034

### 90808 Psytx office 75-80

min Q3 0323 0034

### 90809 Psytx off 75-80

w/e&m Q3 0323 0034

### 90810 Intac psytx off 20-30

min Q3 0322 0034

### 90811 Intac psytx 20-30

w/e&m Q3 0322 0034

### 90812 Intac psytx off 45-50

min Q3 0323 0034

### 90813 Intac psytx 45-50 min

w/e&m Q3 0323 0034

### 90814 Intac psytx off 75-80

min Q3 0323 0034

### 90815 Intac psytx 75-80

w/e&m Q3 0323 0034

### 90845 Psychoanalysis Q3 0323 0034

### 90846 Family psytx w/o

patient Q3 0324 0034

### 90847 Family psytx

w/patient Q3 0324 0034

### 90849 Multiple family group

psytx Q3 0325 0034

### 90853 Group

psychotherapy Q3 0325 0034

### 90857 Intac group

psytx Q3 0325 0034

### 90862 Medication

management Q3 0605 0034

### 90865 Narcosynthesis Q3 0323 0034

### 90880 Hypnotherapy Q3 0323 0034

### 90899 Psychiatric

service/therapy Q3 0322 0034

### 96101 Psycho testing by

psych/phys Q3 0382 0034

### 96102 Psycho testing by

technician Q3 0382 0034

### 96103 Psycho testing admin by

comp Q3 0373 0034

### 96110 Developmental test

lim Q3 0373 0034

### 96111 Developmental test

extend Q3 0373 0034

### 96116 Neurobehavioral status

exam Q3 0382 0034

### 96118 Neuropsych tst by

psych/phys Q3 0382 0034

### 96119 Neuropsych testing by

tec Q3 0382 0034

### 96120 Neuropsych tst admin

w/comp Q3 0382 0034

### 96150 Assess hlth/behave

init Q3 0432 0034

### 96151 Assess hlth/behave

subseq Q3 0432 0034

### 96152 Intervene hlth/behave

### indiv Q3 0432 0034

### 96153 Intervene hlth/behave

group Q3 0432 0034

### 96154 Interv hlth/behav fam

w/pt Q3 0432 0034

### M0064 Visit for drug

monitoring Q3 0607 0034

### 36600 Withdrawal of arterial blood Q3 0035 "0617, 0618, or

8003"

### 43752 Nasal/orogastric w/stent Q3 0272 "0617, 0618, or

8003"

### 71010 Chest x-ray Q3 0260 "0617, 0618, or

8003"

### 71015 Chest x-ray Q3 0260 "0617, 0618, or

8003"

### 71020 Chest x-ray Q3 0260 "0617, 0618, or

8003"

### 92953 Temporary external pacing Q3 0094 "0617, 0618, or

8003"

### 94002 Vent mgmt inpat init day Q3 0079 "0617, 0618, or 8003

"

### 94003 Vent mgmt inpat subq day Q3 0079 "0617, 0618, or 8003

"

### 94660 Pos airway pressure cpap Q3 0078 "0617, 0618, or 8003

"

### 94662 Neg press ventilation cnp Q3 0079 "0617, 0618, or 8003

"

### 94762 Measure blood oxygen level Q3 0097 "0617, 0618, or 8003

"

### 93619 Electrophysiology

evaluation Q3 0085 8000

### 93620 Electrophysiology

evaluation Q3 0085 8000

### 93650 Ablate heart dysrhythm

focus Q3 0085 8000

### 93651 Ablate heart dysrhythm

focus Q3 0086 8000

### 93652 Ablate heart dysrhythm

focus Q3 0086 8000

### 55875 Transperi needle place

pros Q3 0163 8001

### 77778 Apply interstit radiat

compl Q3 0651 8001

### 99205 Office/outpatient visit new Q3

0608 8002

### 99215 Office/outpatient visit est Q3

0607 8002

### G0379 Direct refer hospital

observ Q3 0604 8002

### 99284 Emergency dept visit Q3

0615 8003

### 99285 Emergency dept visit Q3

0616 8003

### 99291 Critical care first hour Q3

0617 8003

### G0384 Lev 5 hosp type B ED

visit Q3 0630 8003

### 76604 Us exam

chest Q3 0265 8004

### 76700 Us exam abdom

complete Q3 0266 8004

### 76705 Echo exam of

abdomen Q3 0266 8004

### 76770 Us exam abdo back wall

comp Q3 0266 8004

### 76775 Us exam abdo back wall

lim Q3 0266 8004

### 76776 Us exam k transpl

w/doppler Q3 0266 8004

### 76831 Echo exam

uterus Q3 0267 8004

### 76856 Us exam pelvic

complete Q3 0266 8004

### 76857 Us exam pelvic

limited Q3 0265 8004

### 76870 Us exam

scrotum Q3 0266 8004

### 74176 Ct abd & pelvis w/o

contrast CH Q3 0331 8005

### 70450 Ct head/brain w/o dye Q3 0332 8005 or

8006

### 70480 Ct orbit/ear/fossa w/o dye Q3 0332 8005 or

8006

### 70486 Ct maxillofacial w/o dye Q3 0332 8005 or

8006

### 70490 Ct soft tissue neck w/o dye Q3 0332 8005 or

8006

### 71250 Ct thorax w/o dye Q3 0332 8005 or

8006

### 72125 Ct neck spine w/o dye Q3 0332 8005 or

8006

### 72128 Ct chest spine w/o dye Q3 0332 8005 or

8006

### 72131 Ct lumbar spine w/o dye Q3 0332 8005 or

8006

### 72192 Ct pelvis w/o dye Q3 0332 8005 or

8006

### 73200 Ct upper extremity w/o dye Q3 0332 8005 or

8006

### 73700 Ct lower extremity w/o dye Q3 0332 8005 or

8006

### 74150 Ct abdomen w/o dye Q3 0332 8005 or

8006

### 74261 Ct colonography dx Q3 0332 8005 or

8006

### 70460 Ct head/brain

w/dye Q3 0283 8006

### 70470 Ct head/brain w/o &

w/dye Q3 0333 8006

### 70481 Ct orbit/ear/fossa

w/dye Q3 0283 8006

### 70482 Ct orbit/ear/fossa

w/o&w/dye Q3 0333 8006

### 70487 Ct maxillofacial

w/dye Q3 0283 8006

### 70488 Ct maxillofacial w/o &

w/dye Q3 0333 8006

### 70491 Ct soft tissue neck

w/dye Q3 0283 8006

### 70492 Ct sft tsue nck w/o &

w/dye Q3 0333 8006

### 70496 Ct angiography

head Q3 0662 8006

### 70498 Ct angiography

neck Q3 0662 8006

### 71260 Ct thorax

w/dye Q3 0283 8006

### 71270 Ct thorax w/o &

w/dye Q3 0333 8006

### 71275 Ct angiography

chest Q3 0662 8006

### 72126 Ct neck spine

w/dye Q3 0283 8006

### 72127 Ct neck spine w/o &

w/dye Q3 0333 8006

### 72129 Ct chest spine

w/dye Q3 0283 8006

### 72130 Ct chest spine w/o &

w/dye Q3 0333 8006

### 72132 Ct lumbar spine

w/dye Q3 0283 8006

### 72133 Ct lumbar spine w/o &

w/dye Q3 0333 8006

### 72191 Ct angiograph pelv

w/o&w/dye Q3 0662 8006

### 72193 Ct pelvis

w/dye Q3 0283 8006

### 72194 Ct pelvis w/o &

w/dye Q3 0333 8006

### 73201 Ct upper extremity

w/dye Q3 0283 8006

### 73202 Ct uppr extremity

w/o&w/dye Q3 0333 8006

### 73206 Ct angio upr extrm

w/o&w/dye Q3 0662 8006

### 73701 Ct lower extremity

### w/dye Q3 0283 8006

### 73702 Ct lwr extremity

w/o&w/dye Q3 0333 8006

### 73706 Ct angio lwr extr

w/o&w/dye Q3 0662 8006

### 74160 Ct abdomen

w/dye Q3 0283 8006

### 74170 Ct abdomen w/o &

w/dye Q3 0333 8006

### 74175 Ct angio abdom w/o &

w/dye Q3 0662 8006

### 74177 Ct abdomen&pelvis

w/contrast CH Q3 0334 8006

### 74178 Ct abd&pelv 1+

section/regns CH Q3 0334 8006

### 74262 Ct colonography dx

w/dye Q3 0283 8006

### 75635 Ct angio abdominal

arteries Q3 0662 8006

### 70336 Magnetic image jaw joint Q3 0336 8007 or

8008

### 70540 Mri orbit/face/neck w/o dye Q3 0336 8007 or

8008

### 70544 Mr angiography head w/o dye Q3 0336 8007 or

8008

### 70547 Mr angiography neck w/o dye Q3 0336 8007 or

8008

### 70551 Mri brain w/o dye Q3 0336 8007 or

8008

### 70554 Fmri brain by tech Q3 0336 8007 or

8008

### 71550 Mri chest w/o dye Q3 0336 8007 or

8008

### 72141 Mri neck spine w/o dye Q3 0336 8007 or

8008

### 72146 Mri chest spine w/o dye Q3 0336 8007 or

8008

### 72148 Mri lumbar spine w/o dye Q3 0336 8007 or

8008

### 72195 Mri pelvis w/o dye Q3 0336 8007 or

8008

### 73218 Mri upper extremity w/o dye Q3 0336 8007 or

8008

### 73221 Mri joint upr extrem w/o dye Q3 0336 8007 or

8008

### 73718 Mri lower extremity w/o dye Q3 0336 8007 or

8008

### 73721 Mri jnt of lwr extre w/o dye Q3 0336 8007 or

8008

### 74181 Mri abdomen w/o dye Q3 0336 8007 or

8008

### 75557 Cardiac mri for morph Q3 0336 8007 or

8008

### 75559 Cardiac mri w/stress img Q3 0336 8007 or

8008

### C8901 "MRA w/o cont, abd" Q3 0336 8007 or

8008

### C8904 "MRI w/o cont, breast, uni" Q3 0336 8007 or

8008

### C8907 "MRI w/o cont, breast, bi" Q3 0336 8007 or

8008

### C8910 "MRA w/o cont, chest" Q3 0336 8007 or

8008

### C8913 "MRA w/o cont, lwr ext" Q3 0336 8007 or

8008

### C8919 "MRA w/o cont, pelvis" Q3 0336 8007 or

8008

### C8932 "MRA, w/o dye, spinal canal " Q3 0336 8007 or

8008

### C8935 "MRA, w/o dye, upper extr" Q3 0336 8007 or

8008

### 70542 Mri orbit/face/neck

w/dye Q3 0284 8008

### 70543 Mri orbt/fac/nck w/o &

w/dye Q3 0337 8008

### 70545 Mr angiography head

w/dye Q3 0284 8008

### 70546 Mr angiograph head

w/o&w/dye Q3 0337 8008

### 70548 Mr angiography neck

w/dye Q3 0284 8008

### 70549 Mr angiograph neck

w/o&w/dye Q3 0337 8008

### 70552 Mri brain

w/dye Q3 0284 8008

### 70553 Mri brain w/o &

w/dye Q3 0337 8008

### 71551 Mri chest

w/dye Q3 0284 8008

### 71552 Mri chest w/o &

w/dye Q3 0337 8008

### 72142 Mri neck spine

w/dye Q3 0284 8008

### 72147 Mri chest spine

w/dye Q3 0284 8008

### 72149 Mri lumbar spine

w/dye Q3 0284 8008

### 72156 Mri neck spine w/o &

w/dye Q3 0337 8008

### 72157 Mri chest spine w/o &

### w/dye Q3 0337 8008

### 72158 Mri lumbar spine w/o &

w/dye Q3 0337 8008

### 72196 Mri pelvis

w/dye Q3 0284 8008

### 72197 Mri pelvis w/o &

w/dye Q3 0337 8008

### 73219 Mri upper extremity

w/dye Q3 0284 8008

### 73220 Mri uppr extremity

w/o&w/dye Q3 0337 8008

### 73222 Mri joint upr extrem

w/dye Q3 0284 8008

### 73223 Mri joint upr extr

w/o&w/dye Q3 0337 8008

### 73719 Mri lower extremity

w/dye Q3 0284 8008

### 73720 Mri lwr extremity

w/o&w/dye Q3 0337 8008

### 73722 Mri joint of lwr extr

w/dye Q3 0284 8008

### 73723 Mri joint lwr extr

w/o&w/dye Q3 0337 8008

### 74182 Mri abdomen

w/dye Q3 0284 8008

### 74183 Mri abdomen w/o &

w/dye Q3 0337 8008

### 75561 Cardiac mri for morph

w/dye Q3 0337 8008

### 75563 Card mri w/stress img &

dye Q3 0337 8008

### C8900 "MRA w/cont,

abd" Q3 0284 8008

### C8902 "MRA w/o fol w/cont,

abd" Q3 0337 8008

### C8903 "MRI w/cont, breast,

uni" Q3 0284 8008

### C8905 "MRI w/o fol w/cont, brst,

un" Q3 0337 8008

### C8906 "MRI w/cont, breast,

bi" Q3 0284 8008

### C8908 "MRI w/o fol w/cont,

breast," Q3 0337 8008

### C8909 "MRA w/cont,

chest" Q3 0284 8008

### C8911 "MRA w/o fol w/cont,

chest" Q3 0337 8008

### C8912 "MRA w/cont, lwr

ext" Q3 0284 8008

### C8914 "MRA w/o fol w/cont, lwr

ext" Q3 0337 8008

### C8918 "MRA w/cont,

pelvis" Q3 0284 8008

### C8920 "MRA w/o fol w/cont,

pelvis" Q3 0337 8008

### C8931 "MRA, w/dye, spinal

canal" Q3 0284 8008

### C8933 "MRA, w/o&w/dye, spinal

canal" Q3 0337 8008

### C8934 "MRA, w/dye, upper

extremity" Q3 0284 8008

### C8936 "MRA, w/o&w/dye, upper

extr" Q3 0337 8008

### 33225 L ventric pacing lead add-on CH Q3

0108 8009

### 33249 Eltrd/insert pace-defib CH Q3

0108 8009