RADIOLOGY ASSOCIATES IMAGING S READY REFERENCE GUIDE

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1 RADIOLOGY ASSOCIATES IMAGING S READY REFERENCE GUIDE

2 CPT Codes CT SCAN Abdomen w/o contrast Abdomen w/ contrast Abdomen w & w/o contrast Abdomen & Pelvis w/o contrast Abdomen & Pelvis w/ contrast Abdomen & Pelvis w/ & w/o contrast Brain w/o contrast Brain w/ contrast Brain w/ & w/o contrast Chest w/o contrast Chest w/ contrast Chest w/ & w/o contrast Cervical spine w/o contrast Cervical spine w/ contrast Cervical spine w/ & w/o contrast CTA Abdomen & Pelvis CTA Abdominal Aorta CTA Aorta w/runoff CTA Carotid Arteries/Neck CTA Coronary Angiogram CTA Chest CTA Head/Brain CTA Lower Extremity CTA Pelvis Only CTA Upper Extremity Lower Extremity w/o contrast Lower Extremity w/ contrast Lower Extremity w/o & w/ contrast Lumbar Spine w/o contrast Lumbar Spine w/ contrast Lumbar Spine w/o & w/ contrast Neck, Soft Tissue w/o contrast Neck, Soft Tissue w/ contrast Neck, Soft Tissue w/o & w/ contrast Orbit, Sella, IACS w/o contrast CT SCAN (cont.) Orbit, Sella, IACS w/ contrast Orbit, Sella, IACS w/o & w/ contrast Pelvis w/o contrast Pelvis w/ contrast Pelvis w/ & w/o contrast Face/Sinus w/o contrast Face/Sinus w/ contrast Face/Sinus w/ & w/o contrast Thoracic Spine w/o contrast Thoracic Spine w/ contrast Thoracic Spine w/ & w/o contrast Upper Extremity w/o contrast Upper Extremity w/ contrast Upper Extremity w/o & w/ contrast PET (TCI & TLI Only) PET Brain Complete PET/CT Head/Neck Complete PET/CT Tumor Complete PET/CT Melanoma Complete NUCLEAR MEDICINE (Deltona Exempt) Bone Scan Limited Bone Scan Whole Body Cardiac/MUGA Cardiac/Thallium Gastric Emptying Study HIDA Scan Renal Scan/Flow & Function Thyroid Uptake & Scan 78014

3 CPT Codes MRI (Deltona Exempt) Abdomen w/ & w/o contrast Brain w/o contrast Brain w/ contrast Brain w/ & w/o contrast Breast Bilateral Breast Unilateral Cardiac w/ contrast Cardiac MRI/Limited Study Cervical Spine w/o contrast Cervical Spine w/ contrast Cervical Spine w/ & w/o contrast Chest (clavicle) w/o contrast Chest (clavicle) w/ contrast Chest (clavicle) w/o & w/ contrast Lower Extremity Joint w/o contrast Lower Extremity Joint w/contrast Lower Extremity Joint w/ & w/o contrast Lower Extremity Non-Joint w/o contrast Lower Extremity Non-Joint w/contrast Lower Extremity Non-Joint w/ & w/o contrast Lumbar Spine w/o contrast Lumbar Spine w/contrast Lumbar Spine w/ & w/o contrast MRA Abdomen MRA Aorta w/runoff MRA Carotids w/o contrast MRA Carotids w/ contrast MRA Carotids w/ & w/o contrast MRA Chest MRA External Carotid Unilateral MRA Head/Neck MRA Head (COW) MRA Pelvis MRA Spinal Canal MRI (CONT.) (Deltona Exempt) MRA Upper Extremity MRCP Myocardium Orbit, Face & Neck w/o contrast Orbit, Face & Neck w/ contrast Orbit, Face & Neck w/o & w/ contrast Pelvis w/o contrast Pelvis w/ contrast Pelvis w/ & w/o contrast Thoracic Spine w/o contrast Thoracic Spine w/contrast Thoracic Spine w/ & w/o contrast Upper Extremity Joint w/o contrast Upper Extremity Joint w/ contrast Upper Extremity Joint w/ & w/o contrast Upper Extremity Non-Joint w/o contrast Upper Extremity Non-Joint w/ contrast Upper Extremity Non-Joint w/ & w/o contrast MAMMOGRAPHY Screening Mammogram Diagnostic Mammogram Bilateral **Should be ordered with Breast US** Diagnostic Mammogram Unilateral **Should be ordered with Breast US** 3D Mammography (SAI, TCI, TLI & POI) Digital Breast Tomosynthesis, Unilateral Digital Breast Tomosynthesis, Bilateral Screening Digital Breast Tomosynthesis, Bilateral G0202 G0204 G

4 CPT Codes X-RAY Cervical Spine Complete Cervical Spine Limited (AP/LAT) Thoracic Spine Complete Thoracic Spine Limited (AP/LAT) Lumbar Spine Complete Lumbar Spine Limited (AP/LAT) Sacrum Sacrum & Coccyx Chest 2 View (AP/LAT) **Please specify left or right. ** Shoulder Complete Shoulder Limited (AP/LAT) Elbow Complete Elbow Limited (AP/LAT) Forearm Wrist Complete Wrist Limited (AP/LAT) Hand Complete Hand Limited (AP/LAT) Finger **Please specify which finger** Hip Hip w/ AP Pelvis Bilateral Pelvis (AP ONLY) Pelvis Complete (AP/LAT) Femur Knee Complete Knee Limited Tibia & Fibula (AP/LAT) Ankle Complete Ankle Limited (AP/LAT) Foot Complete Foot Limited (AP/LAT) Toe **Please specify which toe** ULTRASOUND Abdomen Complete Abdomen Limited Aorta Breast Bilateral/Unilateral Carotid Doppler **NOT screening used as GRAFT surveillance** Echocardiogram MSK-Extremity, Nonvascular limited MSK-Extremity, Nonvascular complete Pelvis Complete Renal Arteries Retroperitoneal (Kidney) Scrotum Segmental Pressures (Deltona Exempt) Soft Tissue Neck Transvaginal Thyroid Venous Doppler Unilateral Venous Doppler Bilateral BONE DENSITY (DEXA) Bone Densitometry (DEXA) WHEN ORDERING BILATERAL STUDIES, THE CPT MUST BE FOR A QUANTITY OF TWO.

5 Scan Table Weight Limit (in lbs) TABLE LIMITS TLI POI PCI SAI TCI DELTONA FL BD XRAY CT / NM 400(forte) 500 (skylight) PET T T US # US # STEREO US ECHO N/A N/A

6 Accepted Insurance Absolute Solutions ADIN Healthcare Aetna AvMed Health Plans Blue Cross Blue Shield Care IQ Cigna Coast 2 Coast Diagnostics CoreChoice Coventry Cypress Care Diagnostics Plus Evolutions Healthcare Florida Health Care Plans (Deltona exempt) Florida True Health Freedom Health GENEX Services GHI (Emblem Health) Health Advantage Network HealthEase Humana Humana Veterans Integrated Health Plan MD Medicare Choice MedFocus Medicaid Medical Partners of America Medicare MedOptions MedWest Molina Healthcare Mountain Benefits MultiPlan NextImage Medical New Jersey Carpenters Fund NIA NovaNet One Call Care Diagnostics Optimum Healthcare PDM Professional Diagnostic Management Preferred Care Partners (Deltona exempt) Prime Health Services Primecare Spreemo Streamline Imaging TechHealth Three Rivers Provider Network Total Network Resources Tricare UnitedHealthcare University of Florida Ped-I-Care US Imaging Network VA Volusia Health Network WellCare

7 Test Preparations THE PATIENT MAY STILL TAKE PRESCRIBED MEDICINES WITH A SMALL AMOUNT OF WATER. MRCP DO NOT EAT or DRINK four (4) hours before exam. MRI Remove all jewelry and eye make-up. Wear comfortable clothes without metal closures. CT ABDOMEN/PELVIS DO NOT EAT or DRINK four (4) hours before exam. May drink water up to appointment time. CT COLONOGRAPHY Please call for special instructions on how to prepare for this test. MAMMOGRAPHY Do not use powders, deodorant/antiperspirant or perfume on the day of your test. These products contain substances that show up on X-ray film and can cause an unsatisfactory exam. Previous mammograms performed outside our centers must be obtained for comparison prior to appointment. NUCLEAR MEDICINE STUDIES (HIDA) Hepatobiliary Scan or Gastric Emptying Study: DO NOT EAT or DRINK six (6) hours before exam. Bone Scan: NO PREP 2 part study (1) receive an injection, (2) return to center 2 to 4 hours later for remainder of exam. Thyroid Uptake Scan, Cardiac Study: Please call for instructions on how to prepare for this test. I-123 MIBG Scan: Your Doctor will prescribe a medication regiment for 1 week prior to the exam. Please consult your physician for more details. FDG/PET Tumor Localization: DO NOT EAT or DRINK anything except water and medication for six (6) hours before exam. ABSOLUTELY NO SUGAR OR ARTIFICIAL SWEETENER for 24 HRS. DIABETIC PATIENTS PLEASE CALL FOR ADDITIONAL MEDICATION AND DIETARY INSTRUCTIONS. ULTRASOUND STUDIES Abdomen, Gallbladder: DO NOT EAT or DRINK anything six (6) hours before exam. CHILDREN Four (4) hours fasting PELVIC Ultrasound: EMPTY your bladder two (2) hours before your exam time. One (1) hour prior to your exam time, drink at least 32 ounces of fluid before arriving for this exam. Bladder must be FULL for this exam. Do NOT urinate until after your exam. No fasting is necessary. FLUOROSCOPY/ABDOMEN STUDIES Upper GI, UGI & Small Bowel, Small Bowel Only: DO NOT EAT or DRINK after midnight of the night before your exam. Small Bowel will take up to four (4) hours to complete. Barium Enema, IVP: Begin clear liquid diet at 12:00 Noon the day before your exam and drink one bottle of Magnesium Citrate. At 6:00 p.m. that same day, drink another bottle of Magnesium Citrate and take 2 Dulcolax tablets. At 10:00 p.m. the evening before your test, take 2 more Dulcolax tablets. Try to drink one eight ounce glass of water each hour from noon to bedtime. These items can be purchased over the counter at any pharmacy. SPECIAL PROCEDURES Please call for instructions on how to prepare for special procedures.

8 Locations St. Augustine Imaging Palm Coast Imaging Town Center Imaging 190 Southpark Blvd., Suite Pine Cone Drive Suite Hospital Drive, Suite 130 St. Augustine, FL Palm Coast, FL Palm Coast, FL T: T: T: F: F: F: Twin Lakes Imaging Port Orange Imaging Radiology Associates 1890 LPGA Blvd., Suite Dunlawton Avenue Imaging Deltona Daytona Beach, FL Port Orange, FL Saxon Blvd., Suite A T: T: Deltona, FL F: F: T: F: Radiology Associates Imaging offers the use of web-based applications for ordering studies and viewing images. It is our goal to always enhance the workflow of referring physicians and their staff to minimize or eliminate wait time on a phone and maximize image quality of the final product. Both programs are easily installed by your RAI Marketing Representative. Please contact your representative to schedule an installation and training session. A board certified radiologist is always available to ensure the highest quality of care for your patients. Like us on Follow us on

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