Addendum M.-Final 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 CH Q3 0373 0034

96103 Psycho testing admin by comp 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

33225 L ventric pacing lead add-on CH Q3 0655 0108

33249 Nsert pace-defib w/lead Q3 0108 0108

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 8003G0384 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 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 abd & pelv w/contrast CH Q3 0334 8006

74178 Ct abd & pelv 1/> 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 800871550 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