cpt & ICD ARTHROGRAM - Non - Conventional w CT

Transcription

1 cpt & ICD The following codes are being provided as a quick reference guide only. Please be sure to consult your office AMA CPT code book to confirm all codes. Breast Procedures CPT Code CTA CPT Code US GUIDED BREAST BIOPSY ABDOMEN EACH ADDITIONAL LESION (USE WITH 19083) ABDOMEN/PELVIS BREAST CYST ASPIRATION 76942, RUN- OFF STUDY (ABDOMINAL AORTA & BILATERAL LWR EXTREMITIES) EACH ADDITIONAL CYST (USE WITH 19000) CHEST (NONCORONARY) ULTRASOUND GUIDED FNA x # OF LESIONS 76942, CORONARY ARTERIES US PLACEMENT OF LOCALIZATION DEVICE HEAD PLACEMENT OF CLIP, METALLIC PELLET, WIRE/NEEDLE, LOWER EXTREMITY RADIOACTIVE SEEDS NECK (CAROTID) EACH ADDITIONAL LESION (USE WITH 19285) PELVIS STEREOTACTIC GUIDED BIOPSY UPPER EXTREMITY EACH ADDITIONAL LESION (USE WITH 19081) MYELOGRAM BREAST CYST ASPIRATION 77031, CERVICAL SPINE 62302, EACH ADDITIONAL CYST (USE WITH 19000) STEREOTACTIC PLACEMENT OF LOCALIZATION WIRE CERVICAL C- 1- C , PLACEMENT OF CLIP, METALLIC PELLET, WIRE/NEEDLE, RADIOACTIVE SEEDS THORACIC SPINE 62303, EACH ADDITIONAL LESION (USE WITH 19283) MR GUIDED BREAST BIOPSY LUMBAR 62304, EACH ADDITIONAL LESION (USE WITH 19085) BREAST CYST ASPIRATION 77021, OR MORE REGIONS (EG, LUMBAR/THORACIC, & + EACH ADDITIONAL CYST (USE WITH 19000) THORACIC/CERVICAL, LUMBAR/CERVICAL) 2 CT Codes based on region MR PLACEMENT OF LOCALIZATION DEVICE POSTERIOR FOSSA 70460, 70010, & PLACEMENT OF CLIP, METALLIC PELLET, WIRE/NEEDLE, or RADIOACTIVE SEEDS CISTERNOGRAPHY 70460, 70015, & + EACH ADDITIONAL LESION (USE WITH 19287) or CT GUIDED BIOPSY ARTHROGRAM - Conventional (RAD) w CT BREAST BIOPSY PER LESION 77012, ELBOW 73201, 24220, BREAST CYST ASPIRATION 77012, HIP 73701, 27093, EACH ADDITIONAL CYST (USE WITH 19000) SHOULDER 73201, 23350, MAMMOGRAPHIC GUIDED BIOPSY KNEE 73701, 27370, BREAST CYST ASPIRATION 77032, 19000, WRIST 73201, 25246, MAMMOGRAPHIC PLACEMENT OF LOCALIZATION WIRE WRIST 3 JOINT 73201, 25246,73115 PLACEMENT OF CLIP, METALLIC PELLET, WIRE/NEEDLE, ANKLE 73701, 27648, RADIOACTIVE SEEDS SACROILIAC (SI) JOINT 27096, EACH ADDITIONAL LESION (USE WITH 19281) TMJ 70487, 21116, POST BIOPSY MAMMOGRAM ARTHROGRAM - Non - Conventional w CT BILATERAL G0204, ELBOW 73201, 24220, UNILATERAL G0206, HIP 73701, 27093, MAMMOGRAPHY SHOULDER 73201, 23350, DIAGNOSTIC BILATERAL TOMOSYNTHESIS KNEE 73701, 27370, DIAGNOSTIC UNILATERAL TOMOSYNTHESIS WRIST 73201, 25246, DIGITAL DIAGNOSTIC BILATERAL G0204, WRIST 3 JOINT 73201, 25246, DIGITAL DIAGNOSTIC UNILATERAL G0206, ANKLE 73701, 27648, DIGITAL SCREENING BILATERAL G0202, SACROILIAC (SI) JOINT 27096, DIGITAL SCREENING BILATERAL WITH TOMOSYNTHESIS G0202, 77052, DIGITAL SCREENING UNILATERAL G , TMJ 21116, 70487, DUCTOGRAM MULTI DUCT 19030, NEEDLE GUIDED BIOPSY DUCTOGRAM SINGLE DUCT 19030, LIVER 47000, LYMPH NODES 38505, THIGH 20206, SURGICAL SPECIMEN KIDNEY - RENAL MASS 50200, ULTRASOUND SOFT TISSUE MASS 20206, BREAST(S) or UNLISTED CT PROCEDURE MRI BREAST UNILATERAL BREASTS BILATERAL 77059

2 CT CPT Code CT CPT Code 3D RECONSTRUCITON W/O POSTPROCESSING LUMBAR SPINE WITHOUT CONTRAST D RECONSTRUCTION WITH POSPROCESSING LUMBAR SPINE WITH CONTRAST ABDOMEN/PELVIS WITHOUT CONTRAST LUMBAR SPINE W- W/O CONTRAST ABDOMEN/PELVIS WITH CONTRAST LUNG SCREENING ABDOMEN/PELVIS W- W/O CONTRAST LOWER EXTREMITY WITHOUT CONTRAST ABDOMEN WITHOUT CONTRAST LOWER EXTREMITY WITH CONTRAST ABDOMEN WITH CONTRAST LOWER EXTREMITY W- W/O CONTRAST ABDOMEN W- W/O CONTRAST MAXILLOFACIAL WITHOUT CONTRAST BRAIN WITHOUT CONTRAST MAXILLOFACIAL WITH CONTRAST BRAIN WITH CONTRAST MAXILLOFACIAL W- W/O CONTRAST BRAIN W- W/O CONTRAST NECK SOFT TISSUE WITHOUT CONTRAST CARDIAC CALCIUM SCORING WITHOUT CONTRAST NECK SOFT TISSUE WITH CONTRAST CARDIAC STRUCTURE AND MORPHOLOGY W/ CONTRAST NECK SOFT TISSUE W- W/OUT CONTRAST CARDIAC STRUCTURE AND MORPHOLOGY - IN THE SETTING ORBITS WITHOUT CONTRAST OF CONGENITAL HEART DISEASE W/ CONTRAST ORBITS WITH CONTRAST CERVICAL SPINE WITHOUT CONTRAST ORBITS W- W/O CONTRAST CERVICAL SPINE WITH CONTRAST PELVIS WITHOUT CONTRAST CERVICAL SPINE W- W/O CONTRAST PELVIS WITH CONTRAST CHEST WITHOUT CONTRAST PELVIS W- W/O CONTRAST CHEST WITH CONTRAST PITUITARY- SELLA WITHOUT CONTRAST CHEST W- W/OUT CONTRAST PITUITARY- SELLA WITH CONTRAST COCCYX WITH CONTRAST PITUITARY- SELLA W- W/O CONTRAST COCCYX WITHOUT CONTRAST POSTERIOR FOSSA WITHOUT CONTRAST COCCYX W/WO CONTRAST POSTERIOR FOSSA WITH CONTRAST DENTAL IMPLANTS WO CONT POSTERIOR FOSSA W- W/O CONTRAST DENTAL SCAN ONLY CASH PAY ONLY SACRUM WITHOUT CONTRAST DENTAL SCAN W PROCESS BOTH CASH PAY ONLY SACRUM WITH CONTRAST DENTAL SCAN WITH PROCESSING CASH PAY ONLY SACRUM W- W/O CONTRAST DNTL SCAN ONLY BOTH TOP AND BOTTOM CASH PAY ONLY SCANOGRAM ELBOW WITHOUT CONTRAST SHOULDER WITHOUT CONTRAST ELBOW WITH CONTRAST SHOULDER WITH CONTRAST ELBOW W- W/O CONTRAST SHOULDER W- W/O CONTRAST ENTEROGRAPHY (ABD & PEL W CONTRAST) 74177, or SINUS LTD WITHOUT CONTRAST FACIAL BONES WITHOUT CONTRAST SINUS WITHOUT CONTRAST FACIAL BONES WITH CONTRAST SINUS WITH CONTRAST FACIAL BONES W- W/O CONTRAST SINUS W- W/O CONTRAST FOLLOW- UP STUDY LIMITED OR LOCALIZED TEMPORAL BONES WITHOUT CONTRAST FOOT- ANKLE WITHOUT CONTRAST TEMPORAL BONES WITH CONTRAST FOOT- ANKLE WITH CONTRAST TEMPORAL BONES W- W/O CONTRAST FOOT- ANKLE W- W/O CONTRAST THIGH- FEMUR WITHOUT CONTRAST FOREARM WITHOUT CONTRAST THIGH- FEMUR WITH CONTRAST FOREARM WITH CONTRAST THIGH- FEMUR W- W/O CONTRAST FOREARM W- W/O CONTRAST THORACIC SPINE - WITHOUT CONTRAST HAND WITHOUT CONTRAST THORACIC SPINE - WITH CONTRAST HAND WITH CONTRAST THORACIC SPINE - W- W/O CONTRAST HAND W- W/O CONTRAST TIB- FIB WITHOUT CONTRAST HIP WITHOUT CONTRAST TIB- FIB WITH CONTRAST HIP WITH CONTRAST TIB- FIB W- W/O CONTRAST HIP W- W/O CONTRAST TMJS WITHOUT CONTRAST HUMERUS WITHOUT CONTRAST TMJS WITH CONTRAST HUMERUS WITH CONTRAST TMJS W- W/O CONTRAST HUMERUS W- W/O CONTRAST UPPER EXTREMITY WITHOUT CONTRAST IACS, ORBIT, SELLA OR POSTERIOR FOSSA W/O CONTRAST UPPER EXTREMITY WITH CONTRAST IACS, ORBIT, SELLA OR POSTERIOR FOSSA W/ CONTRAST UPPER EXTREMITY W- W/O CONTRAST IACS, ORBIT, SELLA OR POSTERIOR FOSSA UROGRAM (ABD PEL W/WO) & W & W/O CONTRAST or KNEE WITHOUT CONTRAST VIRTUAL COLONOSCOPY W/O CONTRAST, DIAGNOSTIC KNEE WITH CONTRAST VIRTUAL COLONOSCOPY WITH CONTRAST, DIAGNOSTIC KNEE W- W/O CONTRAST VIRTUAL COLONOSCOPY W/O CONTRAST, SCREENING KUB ABD/PEL W/O WRIST WITHOUT CONTRAST LARYNX WITHOUT CONTRAST WRIST WITH CONTRAST LARYNX WITH CONTRAST WRITST W- W/O CONTRAST LARYNX W- W/O CONTRAST RADIATION THERAPY PLANNING 77014

3 Fluoroscopy CPT Code Fluoroscopy CPT Code FISTULA SINUS TRACT STUDY 76080, UGI - W- W/O DELAYED FILMS, WITHOUT KUB FLUORO GUID LOC NEEDLE, SPINE SMALL BOWEL STUDY FLUORO GUIDE BX, INJ, ASP UGI - DOUBLE CONTRAST, W- W/OUT DELAYED FILMS, GUIDED BX, INJ, ASPIRATION W/OUT KUB - ADULTS LARGE JOINT (EG, SHOULDER, HIP KNEE) 20610, UGI - DOUBLE CONTRAST, W- W/OUT DELAYED FILMS, INTERMEDIATE JOINT (EG, TMJ, WRIST, ELBOW, ANKLE) 20605, W/OUT KUB - INFANTS/CHILDREN SMALL JOINT (EG, FINGERS, TOES) 20600, UGI - DOUBLE CONTRAST, W- W/OUT DELAYED FILMS LOOPOGRAM 74425, W/ KUB - ADULTS INDEPENDENT STUDY UGI - DOUBLE CONTRAST, W- W/OUT DELAYED FILMS, SNIFF TEST W/ KUB & SMALL BOWEL FOLLOW THROUGH - FLUORO UP TO ONE HOUR INFANTS/CHILDREN FLUORO MORE THAN ONE HOUR UGI - DOUBLE CONTRAST, W- W/OUT DELAYED FILMS W/ FLUORO EVAL OF EXISTING CENTRAL VENOUS ACCESS 36598, & KUB & SMALL BOWEL FOLLOW THROUHG - ADULTS DEVICE or UGI - W- W/O DELAYED FILMS, WITH KUB LUMBAR PUNCTURE (Diagnostic) 62270, UGI - W/SMALL BOWEL FOLLOW THROUGH LUMBAR PUNCTURE (Therapeutic) 62272, GYNECOLOGICAL AND OBSTETRICAL NOSE TO RECTUM EXAMINATION FOR DETECTION OF HYSTERSALPINGOGRAM (AKA HSG) 74740, FOREIGN BODY - CHILD VAGINOGRAM (PERINEOGRAM) BLOOD PATCH 62273, URINARY TRACT PROCEDURE UNLISTED CYSTOGRAPHY & TOMOGRAPHY TO COMPLETE EXAM or GANGLION CYST ASPIRATION INJECTION 20612, IVP - INTRAVENOUS, WITH OR WITHOUT KUB, INJ SINGLE TENDON SHEATH, LIGAMENT 20550, WITH OR WITHOUT TOMOGRAPHY INJ SINUS TRACT - SINOGRAM 76080, IVP ROUTINE - DRIP AND/OR BOLUS TECHNIQUE, 18 YEARS INJECTION VENOGRAM 36005, 75820, OR UNDER SIALOGRAM 70390, IVP - DRIP AND/OR BOLUS TECHNIQUE PERITONEOGRAM 74190, WITH TOMOGRAPHY (ALWAYS W TOMOS IF 18 +) MYELOGRAM - Conventional (RAD) LOOPOGRAM (ANTEGRADE PYELOGRAM) 74425, & POSTERIOR FOSSA 70010, & or or NEPHROSTOGRAM 74425, & CISTERNOGRAPHY 70015, & or or RETROGRADE PYELOGRAM CERVICAL MYELOGRAM URETHROCYSTOGRAPHY - RETROGRADE 74450, URETHROCYSTOGRAPHY - VOIDING (AKA VCUG) 74455, THORACIC MYELOGRAM MEASUREMENT OF POST- VOID RESIDUAL URINE AND/OR BLADDER CAPACITY BY US (USE WITH URINARY TRACT LUMBAR MYELOGRAM CODES IF PERFORMED) THORACENTESIS/PARACENTESIS MYELOGRAM 2 OR MORE REGIONS CHEST TUBE EXTENDED USE PARACENTESIS ARTHROGRAM - Conventional (RAD) THORACENTESIS ANKLE 73615, THORACENTESIS WITH TUBE ELBOW 73085, GASTROINTESTINAL TRACT HIP 73525, BE (BARIUM ENEMA) KNEE 73580, BE AC (BARIUM ENEMA, DOUBLE CONTRAST W/AIR) TMJ ARTHROGRAM 70332, THERAPEUTIC ENEMA WRIST ARTHROGRAM 73115, CHOLANGIOGRAM THROUGH EXISTING T- TUBE 74305, WRIST ARTHROGRAM 3 JOINT 73115, x3 ENTEROCLYSIS SMALL BOWEL 74251, 44500, SACROILIAC (SI) JOINT PHARYNX AND/OR CERVICAL ESOPHAGUS SHOULDER 73040, BARIUM SWALLOW - ESOPHAGUS BARIUM SWALLOW - ESOPHAGUS - MODIFIED FOREIGN BODY REMOVAL - ESOPHAGEAL & or GB - CHOLECYSTOGRAPHY, ORAL CONTRAST GB DD - CHOLECYSTOGRAPHY, ADDITIONAL OR REPEAT EXAM OR MULTIPLE DAY EXAM

4 MRI CPT Code MRI CPT Code ABDOMEN WITHOUT CONTRAST ORBIT, FACE AND/OR NECK WITHOUT CONTRAST ABDOMEN WITH CONTRAST ORBIT, FACE AND/OR NECK WITH CONTRAST ABDOMEN W- W/O CONTRAST ORBIT, FACE AND OR/NECK W- W/O CONTRAST BRACHIAL PLEXUS WITHOUT CONTRAST PELVIS - WITHOUT CONTRAST TO IDENTIFY APICAL LUNG CANCERS PELVIS - WITH CONTRAST BRACHIAL PLEXUS WITH CONTRAST PELVIS - W- W/O CONTRAST TO IDENTIFY APICAL LUNG CANCERS PELVIS W- W/O PROTOCOL STUDY BRACHIAL PLEXUS W- W/O CONTRAST PITUITARY WITHOUT CONTRAST TO IDENTIFY APICAL LUNG CANCERS PITUITARY WITH CONTRAST BRACHIAL PLEXUS WITHOUT CONTRAST PITUITARY W- W/O CONTRAST EVALUATION OF TUMOR IN AXILLA PROSTATE WITHOUT CONTRAST BRACHIAL PLEXUS WITH CONTRAST PROSTATE WITH CONTRAST EVALUATION OF TUMOR IN AXILLA PROSTATE W- W/O CONTRAST BRACHIAL PLEXUS W- W/O CONTRAST SACRUM WITHOUT CONTRAST EVALUATION OF TUMOR IN AXILLA SACRUM WITH CONTRAST BRACHIAL PLEXUS WITHOUT CONTRAST SACRUM W- W/O CONTRAST EVALUATION OF TUMOR IN SHOULDER GIRDLE SINUS WITHOUT CONTRAST BRACHIAL PLEXUS WITH CONTRAST SINUS WITH CONTRAST EVALUATION OF TUMOR IN SHOULDER GIRDLE SINUS W- W/O CONTRAST BRACHIAL PLEXUS W- W/O CONTRAST TEMPORAL/MASTOID (BRAIN) WITHOUT CONTRAST EVALUATION OF TUMOR IN SHOULDER GIRDLE TEMPORAL/MASTOID (BRAIN) WITH CONTRAST BRACHIAL PLEXUS WITHOUT CONTRAST - EVALUATION TO TEMPORAL/MASTOID (BRAIN) W/WO CONTRAST IDENTIFY HEAD/NECK CA TO LEVEL OF THYROID THIGH FEMUR WITHOUT CONTRAST BRACHIAL PLEXUS WITH CONTRAST - EVALUATION TO THIGH FEMUR WITH CONTRAST IDENTIFY HEAD/NECK CA TO LEVEL OF THYROID THIGH FEMUR W- W/O CONTRAST BRACHIAL PLEXUS W- W/O CONTRAST - EVALUATION TO THORACIC SPINE WITHOUT CONTRAST IDENTIFY HEAD/NECK CA TO LEVEL OF THYROID THORACIC SPINE WITH CONTRAST BRAIN - WITHOUT CONTRAST THORACIC SPINE W- W/O CONTRAST BRAIN - WITH CONTRAST TMJ WITHOUT CONTRAST BRAIN - W- W/O CONTRAST UNLISTED PROCEDURE BREAST BILATERAL UPPER EXTREMITY (NON- JOINT) BREAST UNILATERAL FOREARM WITHOUT CONTRAST CARDIAC FOR MORPHOLOGY & FUNCTION FOREARM WITH CONTRAST W/O CONTRAST FOREARM W- W/O CONTRAST CARDIAC FOR MORPHOLOGY AND FUNCTION HAND WITHOUT CONTRAST WITHOUT CONTRAST, WITH STRESS IMAGING HAND WITH CONTRAST VELOCITY FLOW MAPPING (USE WITH 75557, 75559) HAND W- W/O CONTRAST CARDIAC FOR MORPHOLOGY AND FUNCTION HUMERUS WITHOUT CONTRAST W - W/O CONTRAST HUMERUS WITH CONTRAST CARDIAC FOR MORPHOLOGY AND FUNCTION HUMERUS W- W/O CONTRAST W- W/O CONTRAST, WITH STRESS IMAGING SCAPULA WITHOUT CONTRAST VELOCITY FLOW MAPPING (USE WITH 75561, 75563) SCAPULA WITH CONTRAST CERVICAL SPINE WITHOUT CONTRAST SCAPULA W- W/O CONTRAST CERVICAL SPINE WITH CONTRAST UPPER EXTREMITY NON JOINT WITHOUT CONTRAST CERVICAL SPINE W- W/O CONTRAST UPPER EXTREMITY NON JOINT WITH CONTRAST CHEST - WITHOUT CONTRAST UPPER EXTREMITY NON JOINT W- W/O CONTRAST CHEST - WITH CONTRAST UPPER EXTREMITY (JOINT) CHEST - W- W/O CONTRAST ELBOW WITHOUT CONTRAST ENTEROGRAPHY WITHOUT CONTRAST 74181, & ELBOW WITH CONTRAST or ELBOW W- W/O CONTRAST ENTEROGRAPHY WITH CONTRAST 74182, & FINGER WITHOUT CONTRAST or FINGER WITH CONTRAST ENTEROGRAPHY W- W/O CONTRAST 74183, & FINGER W- W/O CONTRAST or SHOULDER WITHOUT CONTRAST FETUS WITHOUT CONTRAST SHOULDER WITH CONTRAST FETUS WITH CONTRAST SHOULDER W- W/O CONTRAST FETUS W- W/O CONTRAST WRITS WITHOUT CONTRAST IACS WITHOUT CONTRAST WRIST WITH CONTRAST IACS WITH CONTRAST WRIST W- W/O CONTRAST IACS WITH- W/O CONTRAST WRIST W- W/O PFIZER PROTOCOL LUMBAR SPINE WITHOUT CONTRAST LUMBAR SPINE WITH CONTRAST LUMBAR SPINE W- W/O CONTRAST MRCP & or 76377

5 MRI CPT Code MRI CPT Code LOWER EXTREMITY (NON- JOINT) MRA FOOT WITHOUT CONTRAST ABDOMEN FOOT WITH CONTRAST CHEST FOOT W- W/O CONTRAST HEAD WITHOUT CONTRAST LOWER EXTREMITY WITHOUT CONTRAST HEAD WITH CONTRAST LOWER EXTREMITY WITH CONTRAST HEAD W- W/O CONTRAST LOWER EXTREMITY W- W/O CONTRAST LOWER EXTREMITY THIGH/FEMUR WITHOUT CONTRAST NECK WITHOUT CONTRAST THIGH/FEMUR WITH CONTRAST NECK WITH CONTRAST THIGH/FEMUR W- W/O CONTRAST NECK W- W/O CONTRAST TIB FIB WITHOUT CONTRAST PELVIS TIB FIB WITH CONTRAST RUN- OFF STUDY (ABDOMINAL AORTA & BILATERAL LWR EXTREMITIES) 74185, x 2 TIB FIB W- W/O CONTRAST SPINAL CANAL AND CONTENTS LOWER EXTREMITY (JOINT) UPPER EXTREMITY ANKLE POST ARTHROGRAM MRV ANKLE WITHOUT CONTRAST MRV HEAD WITHOUT CONTRAST ANKLE WITH CONTRAST MRV HEAD WITH CONTRAST ANKLE W- W/O CONTRAST MRV HEAD WITH W/O CONTRAST HIP WITHOUT CONTRAST OTHER HIP WITH CONTRAST SPECTROSCOPY (ANY AREA OF THE BODY) HIP W- W/O CONTRAST ULISTED MRI PROCEDURE KNEE WITHOUT CONTRAST MYELOGRAM KNEE WITH CONTRAST POSTERIOR FOSSA 70552, 70010, & KNEE W- W/O CONTRAST or LOWER EXTREMITY JOINT WITHOUT CONTRAST CISTERNOGRAPHY 70552, 70015, & LOWER EXTREMITY JOINT WITH CONTRAST or LOWER EXTREMITY JOINT W- W/O CONTRAST CERVICAL SPINE 62302, ARTHROGRAM - Conventional (RAD) W MRI ANKLE 73722, 27648, CERVICAL C- 1- C , ELBOW 73222, 24220, HIP 73722, 27093, THORACIC SPINE 62303, KNEE 73722, 27370, SHOULDER 73222, 23350, LUMBAR 62304, WRIST 73222, 25246, WRIST 3 JOINT 73222, 25246, OR MORE REGIONS (EG, LUMBAR/THORACIC, SACROILIAC (SI) JOINT 27096, THORACIC/CERVICAL, LUMBAR/CERVICAL) TMJ 70336, 21116, and APPROPRIATE 2 MR CODES, BASED ON REGIONS ARTHROGRAM - Non- Conventional W MRI ANKLE 73722, 27648, ELBOW 73222, 24220, HIP 73722, 27093, KNEE 73722, 27370, SHOULDER 73222, 23350, WRIST 73222, 25246, WRIST 3 JOINT 73222, 25246, SACROILIAC (SI) JOINT 27096, TMJ 70336, 21116, 77002

6 Ultrasound CPT Code Ultrasound CPT Code ABDOMEN VASCULAR ABDOMEN LTD ABI SINGLE LEVEL - BILATERAL/UNILATERAL LOWER BACK ABI 2 LEVELS - BILATERAL/UNILATERAL AORTA ABDOMINAL (AORTA BACKWALL) ABI 3 LEVELS - UNILATERAL AAA SCREENING FOR NON- MEDICARE PATIENTS ABI COMPLETE - 3 LEVELS, BILATERAL AAA SCREENING FOR MEDICARE PATIENTS G0389 AORTA AND/OR IVC DUPLEX LIMITED BONE DENSITY MEASUREMENT/INTERPRETATION, AORTA IVC DUPLEX COMPLETE PERIPHERAL BREAST UNILATERAL INCL AXILLA IF PERFORMED ART BILAT LOWER EXTREMITY BREAST UNILATERAL, LIMITED ART BILAT UPPER EXTREMITY CHEST/MEDIASTINUM ART HEMODIALYSIS ACCESS ** AV FISTULA UPPER BACK ART REST STRESS LOWER EXTREMITY EXTREMITY NON VASCULAR COMPLETE ART UNILAT LOWER EXTREMITY EXTREMITY NON VASCULAR LTD ART UNILAT UPPER EXTREMITY AXILLA - INDICATIONS RELATING TO ARM/ARM PIT CAROTID DUPLEX - COMPLETE GROIN CAROTID DUPLEX - LIMITED GALLBLADDER DUPLEX SCAN OF ABDOMINAL, PELVIC, SCROTAL AND/OR INFANT HIPS RETROPERITONEAL ORGANS - COMPLETE INFANT HIPS LIMITED DUPLEX SCAN OF ABDOMINAL, PELVIC, SCROTAL AND/OR HYSTEROSONOGRAPHY (SONOHYSTERGRAPHY) 76831, RETROPERITONEAL ORGANS - LTD KIDNEY DOPPLER PENILE DOPPLER LIVER PENILE DOPPLER FOLLOW UP OR LIMITED NECK/HEAD SOFT TISSUE TRANSCRANIAL DOPPLER - COMPLETE NEONATAL BRAIN TRANSCRANIAL DOPPLER - LIMITED PELVIS LTD - NON OB VENOUS DOPPLER EXT BILATERAL BUTTOCK VENOUS DOPPLER EXT UNILATERAL PENIS THORACENTESIS/PARACENTESIS PERINEUM CHEST TUBE EXTENDED USE PELVIS COMPLETE - NON OB PARACENTESIS PROSTATE VOLUME STUDY THORACENTESIS RENAL COMPLETE THORACENTESIS WITH TUBE RENAL LTD GUIDED BIOPSY RENAL TRANSPLANT THIGH CORE 76942, RETROPERITONEAL COMPLETE THIGH FNA 76942, RETROPERITONEAL LTD THYROID FNA (x # OF NODULES) 76942, SPINAL CANAL THYROID CORE (x # OF NODULES) 76942, SPINAL CANAL INFANTS THYROID CYST ASPIRATION 76942, TRANSVAGINAL APPROACH - NON OB OTHER TESTICULAR/SCROTUM FOLLOW UP STUDY (SPECIFY) THYROID UNLISTED PROCEDURE TRANSRECTAL MEASUREMENT OF POST- VOIDING RESIDUAL URINE URINARY BLADDER AND/OR URINARY BLADDER (NON- IMAGING) OBSTETRICAL VESSEL MAPPING FOR HEMODIALYSIS ACCESS G0365 OB BIOPHYSICAL PROFILE WITH NON- STRESS TESTING MEDICARE PATIENTS OB BIOPHYSICAL PROFILE W/OUT NON- STRESS TESTING MUSCLE INJ OB FOLLOW UP EXAM, PER FETUS SINGLE OR MULTIPLE - 1 OR 2 MUSCLE(S) 20552, OB GREATER THAN 14 WEEKS - SINGLE FETUS SINGLE OR MULTIPLE - 3 OR MORE MUSCLE(S) 20553, EACH ADDITIONAL FETUS (USE IN ADDITION TO 76805) OB LESS THAN 14 WEEKS - SINGLE FETUS EACH ADDITIONAL FETUS (USE IN ADDITION TO 76801) OB FETAL AND MATERNAL EVALUATION PLUS DETAILED FETAL ANATOMIC EXAM, TRANSABDOMINAL + EACH ADDITIONAL FETUS (USE IN ADDITION TO 76811) FETAL ECHOCARDIOGRAPHY FETAL ECHOCARDIOGRAPHY FOLLOWUP / REPEAT STUDY FETAL DOPPLER FETAL DOPPLER FOLLOW UP OR REPEAT STUDY 76828

7 X- ray CPT Code X- ray CPT Code ABDOMNEN - SINGLE VIEW LUMBAR SPINE FLEX EXT ONLY - 2 OR 3 VIEWS SITZMARKS STUDY PER DAY LUMBAR SPINE COMPLETE INCLUDING FLEXION/EXTENSION - MIN 6 VIEWS ABDOMEN - AP PLUS OBLIQUE AND CONE VIEWS MANDIBLE COMPLETE - MIN 4 VIEWS ABDOMEN - COMPLETE INCLUDING DECUBITUS AND/OR MANDIBLE LIMITED - LESS THAN 4 VIEWS ERECT VIEWS ABDOMEN - COMPLETE ACUTE SERIES, INCLUDING MASTOID COMPLETE - MIN 3 VIEWS PER SIDE SUPINE, ERECT, AND/OR DECUBITUS VIEWS + 1 VIEW CHEST AC JOINTS - WITH OR WITHOUT WEIGHTED DISTRACTION MASTOIDS LIMITED - LESS THAN 3 VIEWS PER SIDE ANKLE COMPLETE - MIN 3 VIEWS NASAL BONES COMPLETE MIN 3 VIEWS ANKLE LTD - 2 VIEWS NECK SOFT TISSUE BONE AGE OPTIC FORAMINA BONE LENGTH - SCANOGRAM ORBITS COMPLETE - MIN 4 VIEWS BONE SKELETON SURVEY COMPLETE ORTHOPANTOGRAM AKA "PANORAMIC X- RAY" BONE SKELETON SURVEY LTD PELVIS LTD - 1 OR 2 VIEWS BONE SURVEY INFANT PELVIS COMPLETE - MIN 3 VIEWS CERVICAL SPINE - 2 OR 3 VIEWS PHARYNX OR LARYNX INCLUDING FLOURO AND/OR MAGNIFICATION TECHNIQUE AKA "NASOPHARYNGOGRAM" CERVICAL SPINE - 4 OR 5 VIEWS RIBS BILATERAL - 3 VIEWS CERVICAL SPINE - 6 OR MORE VIEWS RIBS BILATERAL W/PA CHEST - 4 VIEWS CHEST COMPLETE - MIN 4 VIEWS RIBS UNILATERAL - 2 VIEWS CHEST COMPLETE W/FLUOROSCOPY RIBS UNILATERAL W/PA CHEST - MIN 3 VIEWS CHEST SPECIAL VIEWS ( EG, LATERAL, DECUBITUS, BUCKY STUDIES) SACRUM & COCCYX - MIN 2 VIEWS CHEST - SINGLE VIEW - PA SALIVARY GLAND FOR CALCULUS CHEST - 2 VIEWS - PA/LAT SCAPULA CHEST STEREO - FRONTAL SCOLIOSIS STUDY CHEST - 2 VIEWS WITH LORDOTIC PROCEDURE SELLA TURCICA AKA "TURKISH SADDLE" CHEST - 2 VIEWS WITH OBLIQUES SHOULDER LTD - 1 VIEW CHEST - 2 VIEWS WITH FLOUROSCOPY SHOULDER COMPLETE - MIN 2 VIEWS CLAVICLE SI JOINTS COMPLETE - MIN 3 VIEWS ELBOW LTD - 2 VIEWS SI JOINTS LTD - LESS THAN 3 VIEWS ELBOW COMPLETE - MIN 3 VIEWS SINUS/PARANASAL LTD - LESS THAN 3 VIEWS EYE - FOR DETECTION OF FOREIGN BODY SINUS/PARANASAL COMPLETE - MIN 3 VIEWS FACIAL BONES LTD - LESS THAN 3 VIEWS SKULL LTD - LESS THAN 4 VIEWS FACIAL BONES COMPLETE - MIN 3 VIEWS SKULL COMPLETE - MIN 4 VIEWS FEMUR SPINE - 1 VIEW (SPECIFY LEVEL) FINGER SPINE - ENTIRE SURVEY STUDY FOOT LTD - 2 VIEWS STERNOCLAVICULAR JOINT OR JOINTS - MIN 3 VIEWS FOOT COMPLETE - MIN 3 VIEWS STERNUM - MIN 2 VIEWS FOREARM TEETH - SINGLE VIEW HAND LTD - 2 VIEWS TEETH - PARTIAL EXAMINATION, LESS THAN FULL MOUTH HAND COMPLETE - MIN 3 VIEWS TEETH - COMPLETE - FULL MOUTH HEEL (CALCANEUS) THORACIC SPINE - 3 VIEWS HIP BILATERAL - MIN 2 VIEWS EACH WITH AP VIEW OF THORACIC SPINE - MIN 4 VIEWS PELVIS HIP UNILATERAL LTD - 1 VIEW THORACIC SPINE - 2VIEWS - AP/LAT HIP UNILATERAL COMPLETE - MIN 2 VIEWS THORACOLUMBAR SPINE - 2 VIEWS HUMERUS THORACOLUMBAR SPINE - STANDING (SCOLIOSIS) INFANT OR CHILD HIPS AND PELVIS TIBIA FIBULA INFANT - LOWER EXTREMITY TMJ - BILATERAL INFANT - UPPER EXTREMITY TMJ - UNILATERAL INTERNAL AUDITORY MEATI COMPLETE TOE(S) JOINT SURVEY, SINGLE VIEW, 2 OR MORE JOINTS WRIST LTD - 2 VIEWS KNEE - 1 OR 2 VIEWS WRIST COMPLETE - MIN 3 VIEWS KNEE - 3 VIEWS OTHER KNEE AP STANDING - BILATERAL UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE KNEE COMPLETE - 4 OR MORE VIEWS DEXA KUB SCAN BODY FAT ASSESSMENT LUMBAR SPINE - 2 OR 3 VIEWS BONE DENSITY; AXIAL SKELETON (HIPS, SPINE, PELVIS) LUMBAR SPINE - 4 OR MORE VIEWS BONE DENSITY, AXIAL SKELETON, INCLUDING VERTEBRAL FRACTURE ASSESSMENT LUMBAR SPINE FLEX EXT ONLY - 2 OR 3 VIEWS BONE DENSITY; APPENDICULAR SKELETON (RADIUS, WRIST, HEEL) LUMBAR SPINE COMPLETE INCLUDING FLEXION/EXTENSION - MIN 6 VIEWS DEXA SCAN; VERTEBRAL FRACTURE ASSESSMENT ONLY 77086

8 Nuclear Medicine CPT Code Nuclear Medicine CPT Code ABSCESS LOCALIZATION LIMITED 78805, A9569, A9556 * TUMOR LOCALIZATION - MULTIPLE AREAS 78801, A9560, A9572, ABSCESS LOCALIZATION WHOLE BODY 78806, A9569, A9556 * TUMOR LOCALIZATION - WHOLE BODY, SINGLE DAY 78802, A9560, A9572, ABSCESS LOCALIZATION SPECT 78807, A9560, A9572, TUMOR LOCALIZATION - WHOLE BODY SPECT, SINGLE DAY 78803, A9560, A9572, ABSCESS LOCALIZATION SPECT WHOLE BODY 78806, 78807, A9560, A9572, A9569, A9500, A9556 * TUMOR LOCALIZATOIN - WHOLE BODY, 2 OR MORE DAYS 78804, A9560, A9572, ADRENAL IMAGING, CORTEX AND/OR MEDULLA 78075, A9508, A9582 or A9548 * TUMOR LOCALIZATION - WHOLE BODY SPECT, 2 OR MORE DAYS 78803, 78804, A9560, A9572, A9569, A9500, A9556 * BONE MARROW IMAGING LTD AREA 78102, A9541 GASTRIC EMPTYING SCAN xs , A9541 BONE MARROW IMAGING MULTIPLE AREAS 78103, A9541 ACUTE GI BLOOD LOSS IMAGING 78278, A9560 or A9541 * BONE MARROW IMAGING WHOLE BODY 78104, A9541 HIDA SCAN 78226, A9537 BONE SCAN 3 PHASE 78315, A9561 or A9503 * HIDA SCAN WITH PHARMACOLOGIC INTERVENTION (CCK) 78227, A9537, J2805 (kinevac/cck) or J2275 (morphine) BONE OR JOINT IMAGING; LIMITED AREA 78300, A9561 or A9503 * I 131 BODY SCAN 78018, A9528 BONE OR JOINT IMAGING; MULTIPLE AREAS 78305, A9561 or A9503 * LIVER SCAN STATIC ONLY 78201, A9541 BONE SCAN SPECT STUDY LIVER SCAN WITH VASCULAR FLOW 78202, A9541 BONE OR JOINT IMAGING; WHOLE BODY 78306, A9561 or A9503 * LIVER IMAGING SPECT (3D) 78205, A9541 BONE OR JOINT IMAGING; WHOLE BODY WITH SPECT 78306, 78320, A9561 or A9503 * LIVER SPECT SCAN WITH VASCULAR FLOW 78206, A9541 BRAIN IMAGING LESS THAN 4 STATIC VIEWS 78600, A9569 LIVER & SPLEEN IMAGING STATIC ONLY 78215, A9541 BRAIN IMAGING LESS THAN 4 STATIC VIEWS WITH VASCULAR FLOW 78601, A9569 LIVER & SPLEEN IMAGING WITH VASCULAR FLOW 78216, A9541 BRAIN IMAGING MINIMUM 4 STATIC VIEWS 78605, A9569 LYMPHATICS AND LYMPH NODE IMAGING 78195, A9541 BRAIN IMAGING MINIMUM 4 STATIC VIEWS WITH VASCULAR FLOW 78606, A9569 MECKELS SCAN 78290, A9512 BRAIN SPECT SCAN 78607, A9569 MIBG SPECT SCAN I , 78804, A9582 BRAIN IMAGING VASCULAR FLOW ONLY 78610, A9569 MIBG SPECT SCAN , 78804, A9508 CARDIAC SHUNT IMAGING/DETECTION 78428, A9540 MUGA; PLANAR, SINGLE STUDY AT REST OR STRESS 78472, A9560, A9512, A9538 * CEA SPECT SCAN CEA WHOLE BODY SCAN MULTI DAY CEA WHOLE BODY SCAN SINGLE DAY 78803, A9560, A9572, + RIGHT VENTRICULAR EJECTION FRACTION (USE WITH 78472) , A9560, A9572, MUGA; MULTIPLE STUDIES, WALL MOTION STUDY PLUS EJECTION FRACTION, AT REST AND STRESS 78802, A9560, A9572, MUGA SPECT 78473, A9560, A9512, A9538 * 78494, A9560, A9512, A9538 CEA WHOLE BODY MULTI DAY SPECT 78803, 78804, A9560, A9572, A9569, A9500, A9556 * OCTREOSCAN SPECT 78803, A9572 CISTERNOGRAM 78630, 62311, 77003, A9548, OCTREOSCAN WHOLE BODY MULTI DAY 78804, A9572 CSF LEAKAGE DETECTION AND LOCALIZATION OCTRESCAN WHOLE BODY MULTI DAY W/SPECT 78803, 78804, A9572 GALLIUM SCAN LTD AREA - TUMOR LOCALIZATION 78800, A9560, A9572, OCTREOSCAN WHOLE BODY SINGLE DAY 78802, A9572 GALLIUM SCAN WHOLE BODY MULTI DAY - TUMOR LOCALIZATION GALLIUM SCAN WHOLE BODY SINGLE DAY - TUMOR LOCALIZATION 78804, A9560, A9572, 78802, 78803, A9560, A9572, A9569, A9500, A9556 * PARATHYROID IMAGING WITHOUT SPECT PARATHYROID IMAGING WITH SPECT PARATHYROID IMAGING WITH SPECT AND CT FOR ANATOMICAL LOCALIZATION 78070, A , A , A9500

9 Nuclear Medicine CPT Code Nuclear Medicine CPT Code PET CT LIMITED AREA 78814, A9552 SALIVARY GLAND IMAGING 78230, A9512 PET CT SKULL BASE TO MID THIGH 78815, A9552 SERIAL SALIVARY IMAGING 78231, A9512 PET CT WHOLE BODY 78816, A9552 SESTAMIBI SCAN 78803, A9500 PET MYOCARDIAL IMAGING METABOLIC EVALUATION TESTICULAR IMAGING WITH VASCULAR FLOW 78761, A9512 PET MYOCARDIAL PERFUSION; SINGLE STUDY AT REST OR STRESS THYROID UPTAKE SINGLE OR MULTIPLE 78012, A9516 PET MYOCARDIAL PERFUSION; MULTIPLE STUDIES AT REST OR STRESS THYROID IMAGING INCLUDING VASCULAR FLOW, IF PERFORMED 78013, A9516 PET BRAIN METABOLIC EVALUATION 78608, A9552 THYROID IMAGING WITH SINGLE OR MULTIPLE UPTAKES 78014, A9516 PROSTASCINT MULTI DAY SPECT NEEDS ABD/PEL W/WO TOO 78803, 78804, A9507 THYROID CARCINOMA METASTASES LTD 78015, A9528 PROSTASCINT WHOLE BODY SINGLE 78802, A9507 THYROID CARCINOMA METASTASES WITH ADDITIONAL STUDIES 78016, A9528 PROSTASCINT WHOLE BODY MULTI W OUT SPECT 78804, A9507 THYROID CARCINOMA METASTASES WHOLE BODY SCAN 78018, A9528 PULMONARY PERFUSION PARTICULATE ONLY 78580, A THYROID CARCINOMA METASTASES UPTAKE (USE WITH 78018) PULMONARY VENTILATION AND PERFUSION SCAN (AKA VQ SCAN) 78582, A9540, A9567 URETAL REFLUX STUDY (RADIOPHARMACEUTICAL VOIDING CYSTOGRAM) PULMONARY PERUSION AND VENTILATION WITH QUANTITATIVE DIFFERENTIAL 78598, A9540, A URINARY BLADDER RESIDUAL STUDY (USE WITH 78740) QUANTITATIVE DIFFERENTIAL PULMONARY PERFUSION, INCLUDING IMAGING WHEN PERFORMED OTHER RA I 131 THYROID ABLATION THERAPY (#1) 79005, A9517 UNLISTED ENDOCRINE PROCEDURE RENAL FUNCTION STUDY 78725, A9539 UNLISTED HEMATOPOIETIC, RETICULOENDOTHELIAL AND LYMPHATIC PROCEDURE RENAL SCAN W/CAPTOPRIL MULTIPLE STUDIES 78709, A9562, J1940 UNLISTED GASTROINTESTINAL PROCEDURE RENAL SCAN W/CAPTOPRIL SINGLE STUDY 78708, A9562, J1940 UNLISTED MUSCOSKELETAL PROCEDURE RENAL SCAN W/LASIX MULTIPLE STUDIES 78709, A9562, J1940 UNLISTED CARDIOVASCULAR PROCEDURE RENAL SCAN W/LASIX SINGLE STUDY 78708, A9562, J1940 UNLISTED RESPIRATORY PROCEDURE RENAL SCAN MORPHOLOGY UNLISTED NERVOUS SYSTEM PROCEDURE RENAL SCAN WITH VASCULAR FLOW 78701, A9562, A9551, A9539 * UNLISTED GENITOURINARY PROCEDURE RENAL SCAN WITH VASCULAR FLOW AND FUNCTION, SINGLE STUDY W/OUT PHARM INTERVENTION UNLISTED MISCELLANEOUS PROCEDURE RENAL SPECT SCAN UNLISTED RADIOPHARMACEUTICAL THERAPY PROCEDURE SALIVARY GLAND FUNTION STUDY 78232, A9512 INJECTION PROCEDURE FOR RADIOPHARMACEUTICAL LOCALIZATION BY NON- IMAGING PROBE STUDY, INTRAVENOUS 78808

10 Biopsy, Drainge & Aspiration CPT Code Biopsy, Drainage & Aspiration CPT Code Muscle/Soft Tissue with either Bone Superficial (eg, sternum, ilium, rib) Bone Deep (eg, femur, vertebral body) with either Paracentesis with either Thoracentesis Pleura with either Aspiration of Hematoma, Bulla, ABSCES or Cyst with either Lung or Mediastinum with either Aspiration; renal cyst or pelvis with either Bone Marrow with either Aspiration; thyroid cyst with either BONE MARROW - ASPIRATION ONLY with either Incision and Drainage of Hematoma, Seroma or Fluid Collection with either BONE MARROW BIOPSY AND ASPRITATION - MEDICARE PATIENTS Lymph Nodes; superficial 38221, G0364 with either (US), (CT), (FL) or (MR) FLUID COLLECTION DRAINAGE, WITH IMAGING GUIDANCE, SOFT TISSUE (EG, ABSCESS, SEROMA, LYMPHOCELE, CYST) with either FLUID COLLECTION DRAINAGE, WITH IMAGING GUIDANCE, VISCERAL (EG, LIVER, KIDNEY, SPLEEN, LUNG) Liver with either FLUID COLLECTION DRAINAGE, WITH IMAGING GUIDANCE, PERITONEAL OR RETROERITONEAL THROUH ABDOMINAL WALL OR FLANK Pancreas with either FLUID COLLECTION DRAINAGE, WITH IMAGING GUIDANCE, PERITONEAL OR RETROERITONEAL, T- VAG OR T- RECTAL APPROACH Abdominal or Retroperitoneal Mass Kidney Prostate Thyroid; Core Thyroid; FNA (fine needle aspiration) FNA on any area of the body; can be done alone or in addition to a core biopsy with either INTERVERTEBRAL DISC ASPIRATION 62267, with either CHEST TUBE PLACEMENT AND DRAINAGE with either TUNNELED PLEUARAL CATHETER PLACEMENT 32550, with either TUNNELED PLEURAL CATHETER REMOVAL (per lesion) w/either Insertion of Tunneled Intraperitoneal Catheter Insertion of Tunneled Intraperitoneal Catheter with Subcutaneous Port 49419

11 Biopsy, Drainge & Aspiration CPT Code Biopsy, Drainage & Aspiration CPT Code Removal of Tunneled Intraperitoneal Catheter REPAIR OF PERIPHERALLY INSERTED CVC W/OUT PORT OR PUMP 36575, 76937, Contrast Injection for Assessment of Abscess or Cyst Via 49424, Previously Placed Drainage Cath/Tube REPAIR OF PERIPHERALLY INSERTED CVC WITH PORT 36576, 76937, Exchange of Previously Placed Abscess or Drainage 49423, REPLACEMENT (COMPLETE) OF PERIPHERALLY INSERTED Catheter CVC W/OUT PORT OR PUMP 36584, 76937, Injection of Sinus Tract DIAGNOSTIC (Sinogram, 20501, REPLACEMENT OF PERIPHERALLY INSERTED CVC WITH PORT Fistulogram) (CATH ONLY) 36578, 76937, INJECTION OF SINUS TRACT, THERAPEUTIC (NON , REPLACEMENT (COMPLETE) OF PERIPHERALLY INSERTED VASCULAR SCLEROTHERAPY) CVC WITH PORT 36585, 76937, PICCS & PORTS REPAIR OF TUNNELED CVC W/OUT PORT OR PUMP 36575, 76937, NON- TUNNELED CENTRALLY INSERTED < 5 YEARS OLD 36555, 76937, REPAIR OF TUNNELED CVC WITH PORT 36576, 76937, NON- TUNNELED CENTRALLY INSERTED 5 YEARS OLD 36556, 76937, REPLACEMENT OF TUNNELED CVC W/OUT PORT OR PUMP THROUGH SAME VENOUS ACCESS 36581, 76937, REPAIR OF NON- TUNNELED CVC 36575, 76937, REPLACEMENT OF TUNNELED CVC WITH PORT THROUGH SAME VENOUS ACCESS 36582, 76937, REPLACEMENT OF NON- TUNNELED CVC THROUGH SAME VENOUS ACCESS 36580, 76937, REMOVAL OF TUNNELED CVC W/OUT PORT OR PUMP 36589, 76937, TUNNELED CENTRALLY INSERTED W/OUT PORT OR PUMP < 5 YEARS OLD 36557, 76937, REMOVAL OF TUNNELED CVC WITH PORT 36590, 76937, TUNNELED CENTRALLY INSERTED W/OUT PORT OR PUMP 5 YEARS OLD 36558, 76937, REMOVAL OF TUNNELED CVC WITH PUMP 36590, 76937, ^^^ REQUIRING 2 CATHETERS VIA 2 SEPARTE ACCESS SITES 36565, 76937, REMOVAL OF PERIPHERALLY INSERTED CVC 36590, 76937, TUNNELED CENTRALLY INSERTED WITH PORT < 5 YEARS OLD 36560, 76937, DECLOTTING BY THROMBOLYTIC AGENT OF CVC TUNNELED CENTRALLY INSTERTED WITH PORT 5 YEARS OLD 36561, 76937, ^^^ REQUIRING 2 CATHETERS VIA 2 SEPARTE ACCESS SITES 36566, 76937, MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTIVE MATERIAL 36595, MECHANICAL REMOVAL OF INTRACATHETER OBSTRUCTIVE MATERIAL 36596, TUNNELED CENTRALLY INSERTED WITH PUMP 5 YEARLS OLD 36563, 76937, REPOSITIONING OF CVC 36597, REPLACEMENT OF TUNNELED CVC WITH PUMP (CATH ONLY) 36578, 76937, CVC CONTRAST INJECTION 36598, or REPLACEMENT OF TUNNELED CVC WITH PUMP (COMPLETE) THROUGH SAME VENOUS ACCESS 36583, 76937, IVC FILTER PERIPHERALLY INSERTED W/OUT PORT OR PUMP (PICC) < 5 YEARS OLD 36568, 76937, IVC FILTER INSERTION PERIPHERALLY INSERTED W/OUT PORT OR PUMP (PICC) 5 YEARS OLD 36569, 76937, IVC FILTER REPOSITIONING PERIPHERALLY INSERTED WITH PORT < 5 YEARS OLD 36570, 76937, IVC FILTER REMOVAL PERIPHERALLY INSERTED WITH PORT 5 YEARS OLD 36571, 76937, 77001

12 ICD- 9 Abdomen & Pelvic Head & Neck Abdomen Pain RUQ Aphasia Abdomen Pain LUQ Convulsions Abdomen Pain RLQ CVA NOS Abdomen Pain LLQ Dizziness Giddiness Ascites, Other Headaches Ascites, Malignant Lack of Coordination Constipation Mass/Lump Neck/Head Diarrhea Migraine Flatulence Gas Pain MS 340 Hematuria Parkinson s Disease Hepatitis NOS Speech Disturbance Hepatomegaly Stenosis of Carotid Malaise/Fatigue Subdural Hemorrhage Malignant Neo Abd Intra Syncope Malignant Neo Biliary Tract TIA Malignant Neo Colon Malignant Neo Liver Not Spec as Primay or Secondary Orbit, Face & Neck Nausea w/vomit Chronic Sinusitis Nausea w/o vomiting Diplopia Splenomegaly Goiter NOS UTI Hearing Loss Ventral Hernia Orbital Disorder Weight Loss, Abnormal Thyroid Dysfunction Thyroid Nodule Breast Tinnitus Breast Cancer Visual Disturbance Fibrocystic Disease Visual Loss, Both Eyes 369 Lump or Mass Nipple Discharge Spine Pain Breast Cervical Radiculopathy Screening Mammography V76.12 Cervical Pain Screening Mammography, high- risk V76.11 Cervical Spondylosis Cervical Disc Displacement Female Disorders Cervical Stenosis Amenorrhea Degen of Cervical Bleeding Unrelated to Menstrual Cycle Degen of Thoracic Dysfunctional Uterine Bleed Degen of Lumbar Irregular Menstrual Cycle Lumbar Pain Menorrhagia Lumbar Spondylosis Menstrual Disorder Unspecified Lumbar Disc Displacement Oligomenorrhea Lumbar Stenosis OB Size & Date V22.1 Thoracic & Lumbar Radiculopathy Pelvic Pain Thoracic Pain Extremities & Joints Thoracic Spondylosis Bursitis, Elbow Thoracic Disc Displacement Ganglion Cyst of Joint Thoracic Stenosis Joint Disorder NOS Sciatica Joint Effusion, Ankle Joint Effusion, site unspecified Additional Diagnosis Joint Effusion, Hand Cellulitis, Arms Joint Effusion, Shoulder Chest Pain Joint Stiffness NEC Cough Medial Meniscus Tear Numbness Pain Forearm, Wrist Osteoporosis Pain Hand Osteopenia Pain Multi Joint Pain in Limb Pain Shoulder Superficial Swelling Pain Upper Arm Swelling of Limb Pain Ankle, Foot Pain Knee Pain Hip, Pelvic Rotator Cuff Syndrome Shoulder Stiffness Sprain, Strain Rotator Cuff 840.4