Addendum M.-Final HCPCS Codes for Assignment to Composite APCs for CY 2012

HCPCS Code Short DescriptorCI SISingle Code APC Assignment Composite APC Assignment

90801Psy dx interviewQ303230034

90802Intac psy dx interviewQ303230034

90804Psytx office 20-30 minQ303220034

90805Psytx off 20-30 min w/e&mQ303220034

90806Psytx off 45-50 minQ303230034

90807Psytx off 45-50 min w/e&mQ303230034

90808Psytx office 75-80 minQ303230034

90809Psytx off 75-80 w/e&mQ303230034

90810Intac psytx off 20-30 minQ303220034

90811Intac psytx 20-30 w/e&mQ303220034

90812Intac psytx off 45-50 minQ303230034

90813Intac psytx 45-50 min w/e&mQ303230034

90814Intac psytx off 75-80 minQ303230034

90815Intac psytx 75-80 w/e&mQ303230034

90845PsychoanalysisQ303230034

90846Family psytx w/o patientQ303240034

90847Family psytx w/patientQ303240034

90849Multiple family group psytxQ303250034

90853Group psychotherapyQ303250034

90857Intac group psytxQ303250034

90862Medication managementQ306050034

90865NarcosynthesisQ303230034

90880HypnotherapyQ303230034

90899Psychiatric service/therapyQ303220034

96101Psycho testing by psych/physQ303820034

96102Psycho testing by technicianCH Q303730034

96103Psycho testing admin by compQ303730034

96111Developmental test extendQ303730034

96116Neurobehavioral status examQ303820034

96118Neuropsych tst by psych/physQ303820034

96119Neuropsych testing by tecQ303820034

96120Neuropsych tst admin w/compQ303820034

96150Assess hlth/behave initQ304320034

96151Assess hlth/behave subseqQ304320034

96152Intervene hlth/behave indivQ304320034

96153Intervene hlth/behave groupQ304320034

96154Interv hlth/behav fam w/ptQ304320034

M0064Visit for drug monitoringQ306070034

33225L ventric pacing lead add-onCHQ3 06550108

33249Nsert pace-defib w/leadQ3 01080108

36600Withdrawal of arterial bloodQ3 0035"0617, 0618, or 8003"

43752Nasal/orogastric w/stentQ30272"0617, 0618, or 8003"

71010Chest x-rayQ30260"0617, 0618, or 8003"

71015Chest x-rayQ30260"0617, 0618, or 8003"

71020Chest x-rayQ30260"0617, 0618, or 8003"

92953Temporary external pacingQ30094"0617, 0618, or 8003"

94002Vent mgmt inpat init dayQ30079"0617, 0618, or 8003 "

94003Vent mgmt inpat subq dayQ30079"0617, 0618, or 8003 "

94660Pos airway pressure cpapQ30078"0617, 0618, or 8003 "

94662Neg press ventilation cnpQ30079"0617, 0618, or 8003 "

94762Measure blood oxygen levelQ30097"0617, 0618, or 8003 "

93619Electrophysiology evaluationQ300858000

93620Electrophysiology evaluationQ300858000

93650Ablate heart dysrhythm focusQ300858000

93651Ablate heart dysrhythm focusQ300868000

93652Ablate heart dysrhythm focusQ300868000

55875Transperi needle place prosQ301638001

77778Apply interstit radiat complQ306518001

99205Office/outpatient visit newQ3 06088002

99215Office/outpatient visit estQ3 06078002

G0379Direct refer hospital observQ306048002

99284Emergency dept visitQ3 06158003

99285Emergency dept visitQ3 06168003

99291Critical care first hourQ3 06178003
G0384Lev 5 hosp type B ED visitQ306308003

76604Us exam chestQ302658004

76700Us exam abdom completeQ302668004

76705Echo exam of abdomenQ302668004

76770Us exam abdo back wall compQ302668004

76775Us exam abdo back wall limQ302668004

76776Us exam k transpl w/dopplerQ302668004

76831Echo exam uterusQ302678004

76856Us exam pelvic completeQ302668004

76857Us exam pelvic limitedQ302658004

76870Us exam scrotumQ302668004

74176Ct abd & pelvisCHQ303318005

70450Ct head/brain w/o dyeQ303328005 or 8006

70480Ct orbit/ear/fossa w/o dyeQ303328005 or 8006

70486Ct maxillofacial w/o dyeQ303328005 or 8006

70490Ct soft tissue neck w/o dyeQ303328005 or 8006

71250Ct thorax w/o dyeQ303328005 or 8006

72125Ct neck spine w/o dyeQ303328005 or 8006

72128Ct chest spine w/o dyeQ303328005 or 8006

72131Ct lumbar spine w/o dyeQ303328005 or 8006

72192Ct pelvis w/o dyeQ303328005 or 8006

73200Ct upper extremity w/o dyeQ303328005 or 8006

73700Ct lower extremity w/o dyeQ303328005 or 8006

74150Ct abdomen w/o dyeQ303328005 or 8006

74261Ct colonography dxQ303328005 or 8006

70460Ct head/brain w/dyeQ302838006

70470Ct head/brain w/o & w/dyeQ303338006

70481Ct orbit/ear/fossa w/dyeQ302838006

70482Ct orbit/ear/fossa w/o&w/dyeQ303338006

70487Ct maxillofacial w/dyeQ302838006

70488Ct maxillofacial w/o & w/dyeQ303338006

70491Ct soft tissue neck w/dyeQ302838006

70492Ct sft tsue nck w/o & w/dyeQ303338006

70496Ct angiography headQ306628006

70498Ct angiography neckQ306628006

71260Ct thorax w/dyeQ302838006

71270Ct thorax w/o & w/dyeQ303338006

71275Ct angiography chestQ306628006

72126Ct neck spine w/dyeQ302838006

72127Ct neck spine w/o & w/dyeQ303338006

72129Ct chest spine w/dyeQ302838006

72130Ct chest spine w/o & w/dyeQ303338006

72132Ct lumbar spine w/dyeQ302838006

72133Ct lumbar spine w/o & w/dyeQ303338006

72191Ct angiograph pelv w/o&w/dyeQ306628006

72193Ct pelvis w/dyeQ302838006

72194Ct pelvis w/o & w/dyeQ303338006

73201Ct upper extremity w/dyeQ302838006

73202Ct uppr extremity w/o&w/dyeQ303338006

73206Ct angio upr extrm w/o&w/dyeQ306628006

73701Ct lower extremity w/dyeQ302838006

73702Ct lwr extremity w/o&w/dyeQ303338006

73706Ct angio lwr extr w/o&w/dyeQ306628006

74160Ct abdomen w/dyeQ302838006

74170Ct abdomen w/o & w/dyeQ303338006

74175Ct angio abdom w/o & w/dyeQ306628006

74177Ct abd & pelv w/contrastCHQ303348006

74178Ct abd & pelv 1/> regnsCHQ303348006

74262Ct colonography dx w/dyeQ302838006

75635Ct angio abdominal arteriesQ306628006

70336Magnetic image jaw jointQ303368007 or 8008

70540Mri orbit/face/neck w/o dyeQ303368007 or 8008

70544Mr angiography head w/o dyeQ303368007 or 8008

70547Mr angiography neck w/o dyeQ303368007 or 8008

70551Mri brain w/o dyeQ303368007 or 8008

70554Fmri brain by techQ303368007 or 8008
71550Mri chest w/o dyeQ303368007 or 8008

72141Mri neck spine w/o dyeQ303368007 or 8008

72146Mri chest spine w/o dyeQ303368007 or 8008

72148Mri lumbar spine w/o dyeQ303368007 or 8008

72195Mri pelvis w/o dyeQ303368007 or 8008

73218Mri upper extremity w/o dyeQ303368007 or 8008

73221Mri joint upr extrem w/o dyeQ303368007 or 8008

73718Mri lower extremity w/o dyeQ303368007 or 8008

73721Mri jnt of lwr extre w/o dyeQ303368007 or 8008

74181Mri abdomen w/o dyeQ303368007 or 8008

75557Cardiac mri for morphQ303368007 or 8008

75559Cardiac mri w/stress imgQ303368007 or 8008

C8901"MRA w/o cont, abd"Q303368007 or 8008

C8904"MRI w/o cont, breast, uni"Q303368007 or 8008

C8907"MRI w/o cont, breast, bi"Q303368007 or 8008

C8910"MRA w/o cont, chest"Q303368007 or 8008

C8913"MRA w/o cont, lwr ext"Q303368007 or 8008

C8919"MRA w/o cont, pelvis"Q303368007 or 8008

C8932"MRA, w/o dye, spinal canal "Q303368007 or 8008

C8935"MRA, w/o dye, upper extr"Q303368007 or 8008

70542Mri orbit/face/neck w/dyeQ302848008

70543Mri orbt/fac/nck w/o & w/dyeQ303378008

70545Mr angiography head w/dyeQ302848008

70546Mr angiograph head w/o&w/dyeQ303378008

70548Mr angiography neck w/dyeQ302848008

70549Mr angiograph neck w/o&w/dyeQ303378008

70552Mri brain w/dyeQ302848008

70553Mri brain w/o & w/dyeQ303378008

71551Mri chest w/dyeQ302848008

71552Mri chest w/o & w/dyeQ303378008

72142Mri neck spine w/dyeQ302848008

72147Mri chest spine w/dyeQ302848008

72149Mri lumbar spine w/dyeQ302848008

72156Mri neck spine w/o & w/dyeQ303378008

72157Mri chest spine w/o & w/dyeQ303378008

72158Mri lumbar spine w/o & w/dyeQ303378008

72196Mri pelvis w/dyeQ302848008

72197Mri pelvis w/o & w/dyeQ303378008

73219Mri upper extremity w/dyeQ302848008

73220Mri uppr extremity w/o&w/dyeQ303378008

73222Mri joint upr extrem w/dyeQ302848008

73223Mri joint upr extr w/o&w/dyeQ303378008

73719Mri lower extremity w/dyeQ302848008

73720Mri lwr extremity w/o&w/dyeQ303378008

73722Mri joint of lwr extr w/dyeQ302848008

73723Mri joint lwr extr w/o&w/dyeQ303378008

74182Mri abdomen w/dyeQ302848008

74183Mri abdomen w/o & w/dyeQ303378008

75561Cardiac mri for morph w/dyeQ303378008

75563Card mri w/stress img & dyeQ303378008

C8900"MRA w/cont, abd"Q302848008

C8902"MRA w/o fol w/cont, abd"Q303378008

C8903"MRI w/cont, breast, uni"Q302848008

C8905"MRI w/o fol w/cont, brst, un"Q303378008

C8906"MRI w/cont, breast, bi"Q302848008

C8908"MRI w/o fol w/cont, breast,"Q303378008

C8909"MRA w/cont, chest"Q302848008

C8911"MRA w/o fol w/cont, chest"Q303378008

C8912"MRA w/cont, lwr ext"Q302848008

C8914"MRA w/o fol w/cont, lwr ext"Q303378008

C8918"MRA w/cont, pelvis"Q302848008

C8920"MRA w/o fol w/cont, pelvis"Q303378008

C8931"MRA, w/dye, spinal canal"Q302848008

C8933"MRA, w/o&w/dye, spinal canal"Q303378008

C8934"MRA, w/dye, upper extremity"Q302848008

C8936"MRA, w/o&w/dye, upper extr"Q303378008