74176 Abscess Drain; peritoneal Abscess Drain; retroperitoneal 49061

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1 CT and CTA's CT abdomen and pelvis w/o ; renal stone CT abdomen and pelvis; with i.e. enterography CT abdomen and pelvis; w/o followed by with CPT Code Interventional Radiology/Cardiology CPT Code Abscess Drain; peritoneal Abscess Drain; retroperitoneal Angiogram, renal, unilateral CT abdomen w/o followed by Angiogram, renal, bilateral CT abdomen; w/o Biopsy abdominal mass, percutaneous needle CT abdomen; with Biopsy liver, percutaneous needle CT ablation renal radiofrequency Biopsy lung, percutaneous needle CT cervical spine; w/o CT cervical spine; w/o followed by with Biopsy renal, percutaneous needle or trocar Biopsy thyroid, percutaneous core needle CT cervical spine; with Cardiac cath bilateral CT chest (thorax) w/o followed by CT chest (thorax) w/o - high resolution - limited CT chest (thorax) with, chest tube placement Cardiac cath left heart Cardiac cath right heart Cardioversion elective CT CTA Abdomen/Pelvis Panel Carotid Cerebral CT CTA Abdomen/Pelvis Panel; two separate orders/codes CT CTA Chest/Abdomen Panel; two separate orders/codes CT head or brain; w/o, stroke protocol CT head or brain; w/o followed by with 71275, Echo adult or pediatric complete , Echo adult or pediatric limited Echo fetal, order three codes 76827, Echo stress CT head or brain; with Echo transesophageal, TEE CT heart score CT heart; w/o, calcium scoring CT lower extremity; w/o CT lower extremity; w/o followed by Echo transthoracic ; congenital anomalies Echo transthoracic ; congenital anomalies follow-up Echo with doppler ;with bubbles or EKG 12 lead CT lower extremity; with EKG signal averaged 93278

2 CT lumbar spine; w/o CT lumbar spine; w/o followed by with Electrophysiology (EP) study with arrhythmia EP Study without arrhythmia CT lumbar spine; with EP ablation AV node CT maxillofacial area limited w/o, sinus CT maxillofacial area; w/o followed by with EP ablation for SVT EP ablation for V-Tach CT maxillofacial area; with EP Followup study, NIPS CT maxillofacial area; w/o Event monitor external CT neck soft tissue w/o Event monitor implant CT neck soft tissue with Fluoro, lead check or valve CT orbit; sella or posterior fossa; w/o CT orbit; sella or posterior fossa; w/o followed by with CT orbit; sella or posterior fossa; with Holter monitor up to 48 hours ICD insert or replacement with leads ICD insert replacement pulse generator only CT pelvis; w/o ICD non-invasive test (NIPS) CT pelvis; w/o followed by with CT pelvis; with CT soft tissue neck; w/o CT soft tissue neck; w/o followed by with CT soft tissue neck; with CT thoracic spine; w/o CT thoracic spine; w/o followed by with Nephrostogram with needle; percutaneous Nephrostogram through tube or indwelling ureteral catheter Pacemaker insert new dual chamber with leads Pacemaker insert new single chamber with ventricular leads Pacemaker replace dual chamber pulse generator only Pacemaker replace single chamber pulse generator only Patent foramen ovale (PFO) closure CT thoracic spine; with Pericardiocentesis CT upper extremity; w/o Procainamide infusion CT upper extremity; w/o followed by Tilt table evaluation CT urogram Shuntogram, graft or fistula CT upper extremity; with Stress test CTA abdomen; w/o followed by and further sections Thrombolysis AV fistula CTA chest no coronary Valvuloplasty, aortic 92986

3 CTA head and neck (order separately) 70496, Valvuloplasty,mitral CTA head; w/o followed by with CTA heart coronary arteries and cardiac structure Valvuloplasty, pulmonary CTA lower extremity Mammography CTA neck; w/o followed by with CTA pelvis; w/o followed by with Mammo screening digital CTA runoff AAA bilateral lower extremity CTA upper extremity MRI and MRA's MRI spine screening to include 3 separate codes 72146, MRA abdomen; with or w/o General X-ray Mammo breast surgical specimen Mammo diagnostic digital bilateral or unilateral Mammo ductogram or galactogram bilateral Mammo ductogram or galactogram unilateral Mammo needle localization MRA carotid w/o AC joints bilateral MRA carotid with Abdomen 1-view MRA chest; with or w/o Abdomen 2- view MRA head; w/o Abdomen 3- view MRA head; w/o followed by Ankle 1-2 view MRA head; with Ankle 3-view MRA pelvis; with or w/o Arthogram ankle 73615, MRA peripheral runoff MRA spinal canal & contents; with or w/o 73725, Arthogram elbow Arthrogram knee MRA upper extremity; with or w/o Arthrogram shoulder MRI abdomen; w/o Arthrogram wrist MRI abdomen; w/o followed by with Barium enema MRI abdomen; with Barium enema double MRI brain; w/o Bone age (wrist, hand) 77077

4 MRI brain; w/o followed by Bone survey complete MRI brain; with Bone survey limited MRI breast; bilateral Bone survey infant MRI breast; unilateral C-spine minimum 5 views MRI cardiac for morphology and function w/o MRI cardiac for morphology and function w/o and with C-spine minimum 4 views C-spine 1 view MRI cardiac velocity flow map C-spine 2-3 views MRI cervical spine; w/o Pelvis 3 views i.e. cesium implant MRI cervical spine; w/o followed by Chest 2 views MRI cervical spine; with Chest lateral decubitus MRI chest; w/o Chest 4 views MRI chest; w/o followed by with Chest 1 view MRI chest; with Cholangiogram MRI Etris DVT Research scan; scan involves both CPT codes 73718, Cholangiogram T-tube MRI fetal Clavicle MRI lower extremity, any joint w/o Cystogram 3 views MRI lower extremity, any joint w/o followed by with Elbow 2 views MRI lower extremity, any joint with Elbow minimum 3 views MRI lower extremity, other than joint w/o MRI lower extremity, other than joint with MRI lower extremity, other than joint/o Small bowel i.e. enteroclysis Esophagus Esophagus dilatation MRI lumbar spine; w/o Facial bones less than 3 views MRI lumbar spine; w/o followed by Facial bones minimum 3 views MRI lumbar spine; with Feeding tube placement MRI orbit, face and neck; w/o Femur 2 views MRI orbit, face and neck; w/o followed by with Fingers minimum 2 views 73140

5 MRI orbit, face and neck; with Foot 2 views MRI pelvis; w/o Foot minimum 3 views MRI pelvis; w/o followed by Forearm 2 views MRI pelvis; with Cholecystogram MRI temporomandibular joint(s) Cholecystogram (repeat) MRI thoracic spine w/o followed by Small bowel air MRI thoracic spine; w/o GI series air MRI thoracic spine; with GI single ; barium MRI upper extremity, any joint w/o GI single series with small bowel MRI upper extremity, any joint w/o followed by with GI esophagus MRI upper extremity, any joint with Hand 2 views MRI upper extremity, other than joint w/o MRI upper extremity, other than joint w/o followed by with MRI upper extremity, other than joint with Hand minimum 3 views Hip 1 view Hip 2 views MRI pelvis; w/o Hip intraoperative MRI pelvis; w/o followed by Hip bilateral minimum 2 views MRI pelvis; with Humerus 2 views MRI temporomandibular joint(s) Pyelogram IV MRI thoracic spine w/o followed by Infant lower extremity minimum 2 views Infant upper extremity minimum 2 views Nuclear Medicine Shoulder injection Myocardio perfusion imaging i.e. Bruce cardiolite, lexi scan plus stress test Myocardio perfusion imaging i.e. Bruce cardiolite, lexi scan Biliary scan with IV pharm, i.e. Hida Scan with CCK or morphine Myocardio perfusion imaging i.e. Bruce cardiolite, lexi scan; non-stress Biliary scan with IV pharm, ie Hida Scan w CCK, morphine Intrathecal injection with Intrathecal chemo injection Intrathecal radioisotope injection Intrathecal bacolofen injection Kidney, ureter and bladder, ie KUB 74000

6 Biliary scan no IV pharm; Hida Scan Knee 1 or 2 views Blood flow study Knee 3 views Bone marrow scan Knee 4 or more views Bone SPECT Knee 1 view bilateral standing Bone scan limited; isolated body part L-spine flexion and extension minimum 4 views Bone scan 3 phase; osteomyelitis L-spine minimum 4 views Bone scan whole body; arthritis, known cancer, pain L-spine 1 view Breast scan L-spine 2 or 3 views Cisternogram; normal pressure hydrocephalus, CSF leak GE reflux study; gastroesphogitis, heart burn Bone length studies Loopogram GI blood loss study; active bleeding Lumbar puncture; diagnostic 62270, Gallium and infection scan; bone, tissue, organ Lumbar puncture; therapeutic for drainage of CSF by needle or catheter 62272, Gastric emptying study Mandible complete Gated wall motion stress study Mandible less than 4 views Kidney imaging DMSA; vascular structure Mastoid less than 3 views Kidney scan with pharm; vascular flow and function Kidney scan w/o pharm; vascular flow and function Kidney with and w/o pharm; vascular flow and function Kidney with flow GFR; vascular flow and function Mastoid minimum 3 views Myelogram cervical Myelogram complete Myelogram lumbar LeVeen denver shunt scan Myelogram thoracic Liver spleen scan Nasal bones minimum 3 views Lung differential perfusion only; measure effectiveness in case of lobectomy Lung scan perfusion; COPD, restrictive airway disease Lung scan ventilation and perfusion; VQ scan OS calcis 2 views Orbits minimum 4 views Panorex Lymphoscintigraphy Peds foreign body, nose to rectum MIBG scan tumor localization; pheochromocytoma Pelvis 1 or two views 72170

7 Meckel's abdomen scan; meckels diverticulum, GI bleeding Octreotide or Onocoscint scan; adrenal tumors Pelvis minimum 3 views Pyelogram retrograde Parathyroid scan Ribs bilateral 3 views Parathyroid scan and SPECT Ribs bilateral 3 views with chest Quadrantramet therapy IV Ribs unilateral 2 views with chest Salivary gland scan Ribs unilateral 2 views Testicular scan SI joint less than 3 views Thyroid multi uptake only SI joint minimum 3 views Thyroid scan Sacrum and/or coccyx Thyroid scan and uptake Salpingogram Thyroid whole body Scapula Thyroid single uptake Scoliosis single view Thyroid therapy Scoliosis 2 views Shoulder 1 view Ultrasound Shoulder minimum 2 views US ankle Brachial Indices; ABI Shunt placement series, order three codes 70250, US pelvis-transabdominal; limited Sialogram 70390, US upper extremity arterial; unilateral Sinogram 76080, US AAA screening; Medicare only G0389 Sinus less than 3 views US abdomen complete, solid organs of upper abdomen US abdomen -limited area, liver, gallbladder, pancreas; right upper quandrant US abdomen-complete retroperitoneal, structure of kidneys, aorta or nodes US abdomen-limited retroperitoneal, structure of kidneys, aorta or nodes US abdominal Doppler limited, pelvis, scrotum, testes ; vascular Sinus minimum 3 views Skull less than 4 views Skull minimum 4 views Small bowel Soft tissue neck US amniocentesis Spine complete 2 views US aorta; limited, structure, AAA Spine single view 72020

8 US biophysical Profile-w/o non-stress test Sternoclavicular joint minimum 3 views US breast brachytherapy Sternum 2 views US breast; unilateral or bilateral Swallowing study US carotid duplex; bilateral TMJ bilateral US carotid duplex; unilateral TMJ unilateral US cranial; infant Thoracic spine 2 views US doppler umbilical artery Thoracic spine 3 views US duplex great vessels Thoracic spine 4 views US extremity imaging; nonvascular Thoracic-Lumbar 2 views US extremity imaging; vascular Tibia-fibula 2 views US follow-up cranial Toes minimum 2 views US hemodialysis access; shunt flow Tomogram US infant hips; up to 5 months Urethrogram US intracranial duplex artery; complete, vasospasm US intracranial duplex artery; limited, vasospasm Venogram bilateral Venogram unilateral US kidneys, aorta; limited Voiding cystouretrogram 74455, US localization clip placement Wrist 2 views US lower extremity arterial; bilateral Wrist minimum 3 views US lower extremity arterial; unilateral Zygomatic arches less than 3 views US lower extremity venous; bilateral US lower extremity venous; unilateral Elab US mammosite complex EEG Routine US mammosite simple EEG Sleep Deprived US middle cerebral artery; fetal EMG two extremity US non-invasive peripheral vascular-after stress US non-invasive peripheral vascularbilateral; Peripheral Vascular Resistance EMG four extremity Evoked response audio complete 92585

9 US OB < 4 weeks, transabdominal; first trimester; single gestation US OB < 4 weeks, transabdominal; first trimester; each additional gestation US OB > 4 weeks, transabdominal; complete with detailed fetal anatomic examination, single gestation (normal 20 week US) US OB > 4 weeks, transabdominal; complete with detailed fetal anatomic examination, each additional gestation (normal 20 week US) US OB > 4 weeks, transabdominal; limited (fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume) Evoked response lower limbs Evoked response upper limbs Evoked response visual Evoked response upper & lower limbs US OB > 14 weeks, transabdominal Endo US OB > 14 weeks, transabdominal; each additional gestation US OB transvaginal (severe obesity or < 12 weeks gestation) US OB follow-up, transabdominal; reevaluation of fetal size or organ systems suspected or confirmed on previous scan Anoscopy w biopsy Bronchoscopy diagnostic Bronchoscopy with biopsy US paracentesis Bronchoscopy with needle aspiration US pelvic brachytherapy Bronchoscopy with foreign body removal US pelvic duplex; ovaries Colonoscopy US pelvis vascular; bilateral US pelvis vascular; unilateral Colonoscopy screen high risk (Medicare) Colonoscopy screen low risk (Medicare) G0105 G0121 US pelvis; limited; follicle study Esophageal motility study US pelvis-transabdominal-complete Esophogeal motility with high resolution 0240T US pleural/chest/mediastinum effusion Esophogoscopy rigid or flexible US pseudo aneurysm compression EGD primary US kidney EGD with biopsy US renal doppler; complete bilateral kidneys EGD with Peg placement US renal doppler; limited, one kidney EGD with foreign body removal US renal transplant EGD with dilatation esophagus US sonohistography Endoscopy small intestine 44360

10 US spinal canal and contents ERCP diagnostic US testicle; scrotum and contents ERCP with stone removal US thoracentesis ERCP with biliary or pancreatic stent placement US thyroid; soft tissue of head and neck Gastrostomy tube change US transvaginal; gynecology Proctosigmoidoscopy US upper extremity arterial; bilateral Reflux test with telemetry US upper extremity arterial; unilateral Sigmoidoscopy flexible US upper extremity venous; bilateral US upper extremity venous; unilateral Respiratory Therapy Arterial Blood Gas Sleep Lab Carboxyhemoglobin Home Sleep Test Minimum 4 Channels or G0399 Polysomnogram < 6 years Chest percussive therapy; initial Chest percussive therapy; subsequent Polysomnogram > 6 years DFA influenza specimen Polysomnogram MSLT DLCO diffusion study only Polysomnogram sleep apnea Lung volume only Polysomnogram CPX Lung volume w/dlco; spirometry diffusion capacity Methacholine challenge CRNA Methemoglobin Upper GI endo procedure Nebulizer treatment Lower GI endo procedure Nebulizer pentamidine treatment Interventional radiology venous Pulse oximetry; one time measure Anorectal procedure Pulse oximetry; multiple; exercise/discharge Pulse oximetry; titrate Peak flow; initial PFS compelte 94727

11 Lung Volume w/dlco Before & after bronch eval Difussion capacity PFT complete w ABG Lung Volume w/dlco Before & after bronch eval Difussion capacity Arterial blood gas Portable sleep study Overnight sleep test 2 channel Home sleep test minimun 4 channel Pulmonary rehab session G0399 G0424 Screen w bronch Scrren/spirometry/FV loop Sputum induction Sputum induction for TB/AFB Weaning parameters TTOT procedure Disclaimer: This is a list of commonly ordered exams/procedures and their associated CPT codes. This list is not all inclusive. Further questions should be directed to clinic coding staff.

CT abdomen; with contrast 74160 Cardiac cath bilateral 93453. CT ablation renal radiofrequency 50592 Cardiac cath left heart 93452

CT abdomen; with contrast 74160 Cardiac cath bilateral 93453. CT ablation renal radiofrequency 50592 Cardiac cath left heart 93452 CT and CTA's CT abdomen and pelvis w/o ; renal stone CT abdomen and pelvis; with i.e. enterography CT abdomen and pelvis; w/o followed by with CPT Code 74176 CT abdomen w/o followed by 74170 CT abdomen;

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