Addendum M.-Proposed 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 

technicianQ303820034

96103Psycho testing admin by 

compQ303730034


96110Developmental test 

limQ303730034


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


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 & pelvis w/o 

contrastCHQ303318005


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 abdomen&pelvis 

w/contrastCHQ303348006


74178Ct abd&pelv 1+ 

section/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


33225L ventric pacing lead add-onCHQ3 

01088009

33249Eltrd/insert pace-defibCHQ3 

01088009