Department of Radiology DX PROCEDURES

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1 ABDOMEN 1 VIEW ABDOMEN ACUTE COMP INCL CXR ABDOMEN AP & OBL & CONED VIEWS ABDOMEN COMP INCL DECUB/ERECT ABSCESS FISTULA OR SINUS TRACT AC JOINTS BILAT W OR WO WEIGHT ANKLE 1 VIEW LEFT ANKLE 1 VIEW RIGHT ANKLE 2 VIEWS LEFT ANKLE 2 VIEWS RIGHT ANKLE ARTHROGRAM INJ PROC ANKLE ARTHROGRAM S&I LEFT ANKLE ARTHROGRAM S&I RIGHT ANKLE COMP MIN 3 VIEWS LEFT ANKLE COMP MIN 3 VIEWS RIGHT ARTHRITIS/JOINT SURVEY JUVEN BARIUM ENEMA COLON BARIUM ENEMA W/AIR CONTRAST BONE AGE HEMISKELETON BONE AGE STUDIES BONE LENGTH SCANOGRAM BONE SURVEY COMPLETE BONE SURVEY INFANT UP TO 2 YRS BONE SURVEY LIMITED CALCANEUS MIN 2 VIEWS LEFT CALCANEUS MIN 2 VIEWS RIGHT C-ARM FLUOROSCOPY CHEST 1 VIEW CHEST 2 VIEWS CHEST COMPLETE MIN 4 VIEWS CHEST SPECIAL VIEWS OBL DECUB CHEST WITH APICAL LORDOTIC CHEST WITH FLUORO CHEST WITH OBLIQUES CHEST/ABD COMBINED NEONATE CHOC EMP/SINGLE VIEW CHEST CHOLANG EXIST TUBE INJ PROC CHOLANGIOGRAM EXIST T-TUBE S&I CHOLANGIOGRAM OPER AD SET S&I CHOLANGIOGRAM OPERATIVE S&I CHOLECYSTOGRAM ORAL CONTRAST CLAVICLE COMPLETE LT CLAVICLE COMPLETE RT COLONIC TRANSIT TIME CYSTO W INSERT URETERAL STENT CYSTO W/INSERT URETERAL STENT CYSTO W/REMOVAL/MANIP/CALCULUS CYSTO/VOIDING URETHRO INJ PROC CYSTOGRAM MIN 3 VIEWS S&I DEFECOGRAPHY 74270

2 ELBOW 1 VIEW LEFT ELBOW 1 VIEW RIGHT ELBOW 2 VIEWS LEFT ELBOW 2 VIEWS RIGHT ELBOW ARTHROGRAM INJ PROC ELBOW ARTHROGRAM S&I LEFT ELBOW ARTHROGRAM S&I RIGHT ELBOW COMPLETE MIN 3 VIEWS LT ELBOW COMPLETE MIN 3 VIEWS RT ENTIRE LOWER EXTREMITY LT ENTIRE LOWER EXTREMITY RT ENTIRE UPPER EXTREMITY LT ENTIRE UPPER EXTREMITY RT ESOPH PHARYNX/CERVICAL ESOPHAGRAM EYE FOR FOREIGN BODY FACIAL BONES COMP MIN 3 VWS FACIAL BONES LESS THAN 3 VWS FEMUR 1 VIEW LEFT FEMUR 1 VIEW RIGHT FEMUR 2 VIEWS LEFT FEMUR 2 VIEWS RIGHT FINGER MIN 2 VIEWS INDEX LEFT FINGER MIN 2 VIEWS INDEX RIGHT FINGER MIN 2 VIEWS LETTLE LEFT FINGER MIN 2 VIEWS LITTLE RIGH FINGER MIN 2 VIEWS MIDDLE LEFT FINGER MIN 2 VIEWS MIDDLE RIGH FINGER MIN 2 VIEWS RING LEFT FINGER MIN 2 VIEWS RING RIGHT FINGER MIN 2 VIEWS THUMB LEFT FINGER MIN 2 VIEWS THUMB RIGHT FISTULA SINUS TRACT INJECTION FLUORO FOR LITHO LEFT FLUORO FOR LITHO RIGHT FLUORO GUID LOC NDL OR CATH FLUORO GUID NDL PLACE BXASINJL FLUORO GUIDLOC SPINAL INJ PROC FLUORO MORE THAN 1HR NON RAD P FLUORO SEPARATE PROC UP TO 1HR FLUOROSCOPY FOR PAIN MGMT FOOT 1 VIEW LEFT FOOT 1 VIEW RIGHT FOOT 2 VIEWS LEFT FOOT 2 VIEWS RIGHT FOOT COMPLETE MIN 3 VIEWS LEFT FOOT COMPLETE MIN 3 VIEWS RIGH FOREARM 1 VIEW LEFT FOREARM 1 VIEW RIGHT FOREARM 2 VIEWS LEFT 73090

3 FOREARM 2 VIEWS RIGHT HAND 1 VIEW LEFT HAND 1 VIEW RIGHT HAND 2 VIEWS LEFT HAND 2 VIEWS RIGHT HAND COMP MIN 3 VIEWS LEFT HAND COMP MIN 3 VIEWS RIGHT HIP ARTHRO INJ PROC W/ ANESTH HIP ARTHRO INJ PROC W/O ANESTH HIP ARTHROGRAM S&I LEFT HIP ARTHROGRAM S&I RIGHT HIP IN SURGERY LEFT HIP IN SURGERY RIGHT HIP UNILAT 1 VIEW LEFT HIP UNILAT 1 VIEW RIGHT HIP UNILAT 2 VIEWS LEFT HIP UNILAT 2 VIEWS RIGHT HIPS BILAT INCL AP PELVIS HUMERUS 1 VIEW LEFT HUMERUS 1 VIEW RIGHT HUMERUS MIN 2 VIEWS LEFT HUMERUS MIN 2 VIEWS RIGHT HYSTEROSALPINGOGRAM CATH INTRO HYSTEROSALPINGOGRAM S&I ILEAL CONDUIT/LOOPOGRAM INJ PR INJ W/FLUORO, EVAL CV DEVICE INSERT INDWELLING CATHETER INSERT OF INDWELLING CATHETER INTERNAL AUDITORY MEATI COMP INTRAVENOUS PYELOGRAM JOINT/BURSA INJECT OR ASPIRATI KNEE 1 OR 2 VIEWS LEFT KNEE 1 OR 2 VIEWS RIGHT KNEE 3 VIEWS LEFT KNEE 3 VIEWS RIGHT KNEE ARTHROGRAM INJ PROC KNEE ARTHROGRAM S&I LEFT KNEE ARTHROGRAM S&I RIGHT KNEE COMP 4 OR MORE VIEWS LEFT KNEE COMP 4 OR MORE VIEWS RIGH LOWER EXT INFANT MIN 2 VWS LT LOWER EXT INFANT MIN 2 VWS RT MANDIBLE COMPLETE MIN 4 VIEWS MANDIBLE LESS THAN 4 VIEWS MANUAL STRESS FOR JOINT BY PHY MASTOIDS COMPLETE MIN 3 VIEWS MASTOIDS LESS THAN 3 VIEWS NASAL BONES COMP MIN 3 VWS NECK SOFT TISSUE NOSE TO RECTUM FOR F/B CHILD 76010

4 OCG ADDL/RPT/MULTIDAY EXAM OPTIC FORAMINA ORBITS COMPLETE MIN 4 VIEWS PEL & HIPS INFANT/CHILD MIN 2V PELVIS 1 OR 2 VIEWS PELVIS COMPLETE MIN 3 VIEWS RETROGRADE UROGRAPHY REVIEW OF OUTSIDE RAD EXAM RIB BILAT MIN 4 VIEWS W/PA CXR RIBS BILAT 3 VIEWS RIBS UNILAT 2 VIEWS LT RIBS UNILAT 2 VIEWS RT RIBS UNILAT MIN 3 VWS PACXR RT RIBS UNILAT PACXR MIN 3 VWS LT SACROILIAC JOINTS MIN 3 VIEWS SACRUM AND COCCYX MIN 2 VIEWS SALIVARY GLAND FOR CALCULUS LT SALIVARY GLAND FOR CALCULUS RT SC JOINT OR JOINTS MIN 3 VIEWS SCAPULA COMPLETE LEFT SCAPULA COMPLETE RIGHT SCOLIOSIS SUPINE AND ERECT SELLA TURCICA SHOULDER 1 VIEW LEFT SHOULDER 1 VIEW RIGHT SHOULDER ARTHROGRAM INJ PROC SHOULDER ARTHROGRAM S&I LEFT SHOULDER ARTHROGRAM S&I RIGHT SHOULDER COMP MIN 2 VIEWS LEFT SHOULDER COMP MIN 2 VIEWS RT SHUNTOGRAM S&I SIALOGRAM S&I LT SIALOGRAM S&I RT SIALOGRAPHY INJ PROC SINUSES PARANASAL COMP MIN 3VW SINUSES PARANASAL LESS THAN 3V SJH SINGLE VIEW CHEST SKULL COMPLETE MIN 4 VIEWS SKULL LESS THAN 4 VIEWS SMALL BOWEL SERIES SPINE CERVICAL 1 VIEW SPINE CERVICAL 2 OR 3 VIEWS SPINE CERVICAL MIN 4 VIEWS SPINE CERVICAL W/FLEX OR EXT SPINE ENTIRE SURVEY SPINE LUMBAR 1 VIEW SPINE LUMBAR 2 OR 3 VIEWS SPINE LUMBAR BEND ONLY 4 VIEWS SPINE LUMBAR COMP INCL BENDING SPINE LUMBAR MIN 4 VIEWS 72110

5 SPINE THORACIC 1 VIEW SPINE THORACIC 2 VIEWS SPINE THORACIC 3 VIEWS SPINE THORACOLUMBAR 2 VIEWS SPINE TL STANDING (SCOLIOSIS) STERNUM MIN 2 VIEWS SURGICAL SPECIMEN TIBIA AND FIBULA 1 VIEW LEFT TIBIA AND FIBULA 1 VIEW RIGHT TIBIA AND FIBULA 2 VIEWS LEFT TIBIA AND FIBULA 2 VIEWS RIGHT TMJ OPEN AND CLOSED BILAT TMJ OPEN AND CLOSED UNILAT LT TMJ OPEN AND CLOSED UNILAT RT TOE 1ST LEFT TOE 1ST RIGHT TOE 2ND LEFT TOE 2ND RIGHT TOE 3RD LEFT TOE 3RD RIGHT TOE 4TH LEFT TOE 4TH RIGHT TOE 5TH LEFT TOE 5TH RIGHT TOMOGRAPHY SINGLE PLANE TUBE/CATH CHANGE PERC W/CON S& UGI & SB W/AIR CONTRAST UGI AIR/HD, W/KUB UGI AIR/HD, W/O KUB UGI AND SMALL BOWEL UGI SERIES WITH KUB UGI SERIES WITHOUT KUB UNLISTED RADIOLOGY PROCEDURE UPPER EXTREM INFANT 2 VIEWS LT UPPER EXTREM INFANT 2 VIEWS RT URETHROCYSTOGRAM RETRO INJ PRO URETHROCYSTOGRAM S&I UROGRAPHY ANTEGRADE NEPH/LOOP UROGRAPHY IV W OR WO KUB TOMO UROGRAPHY W/NEPHROTOMOGRAPHY VENOGRAM BILAT S&I VENOGRAM UNILAT LEFT S&I VENOGRAM UNILAT RIGHT S&I VENOGRAPHY EXTREMITY INJ PROC VOIDING CYSTOURETHROGRAM S&I WRIST 1 VIEW LEFT WRIST 1 VIEW RIGHT WRIST 2 VIEWS LEFT WRIST 2 VIEWS RIGHT WRIST ARTHROGRAM INJ PROC 25246

6 WRIST ARTHROGRAM S&I LEFT WRIST ARTHROGRAM S&I RIGHT WRIST COMP MIN 3 VIEWS LEFT WRIST COMP MIN 3 VIEWS RIGHT WRITTEN CONSULTATION-COMPLEX 76140

DX PROCEDURES ANGIO CERVICOCEREBRAL INC ORIG 75650 ANGIO EXTREMITY BILAT S&I 75716 ANGIO EXTREMITY UNILAT S&I RT

DX PROCEDURES ANGIO CERVICOCEREBRAL INC ORIG 75650 ANGIO EXTREMITY BILAT S&I 75716 ANGIO EXTREMITY UNILAT S&I RT DX PROCEDURES NAME CPT CODE ABDOMEN 1 VIEW 74000 ABDOMEN ACUTE COMP INCL CXR1 74022 ABDOMEN AP & OBL & CONED VIEWS 74010 ABDOMEN COMP INCL DECUB/ERECT 74020 ABSCESS FISTULA OR SINUS TRACT 76080 AC JOINTS

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