CPT * Codes Included in AIM Preauthorization Program for 2013 With Grouper Numbers

Transcription

1 CPT * Codes Included in AIM Preauthorization Program for 2013 With Grouper Numbers Computerized Tomography (CT) CPT Description Abdomen CT abdomen; w/o contrast CT abdomen; with contrast CT abdomen; w/o contrast followed by contrast Chest CT thorax; w/o contrast CT thorax; with contrast CT thorax; w/o contrast followed by contrast Upper CT upper extremity; w/o contrast Extremity CT upper extremity; with contrast CT upper extremity; w/o contrast followed by contrast Lower CT lower extremity; w/o contrast Extremity CT lower extremity; with contrast CT lower extremity; w/o contrast followed by contrast Head CT head or brain; w/o contrast CT head or brain; with contrast CT head or brain; w/o contrast followed by contrast Orbit CT orbit, sella or posterior fossa; w/o contrast CT orbit, sella or posterior fossa; with contrast CT orbit, sella or posterior fossa; w/o contrast followed by contrast Sinus CT maxillofacial area; w/o contrast CT maxillofacial area; with contrast CT maxillofacial area; w/o contrast followed by contrast Neck CT soft tissue neck; w/o contrast CT soft tissue neck; with contrast CT soft tissue neck; w/o contrast followed by contrast Pelvis CT pelvis; w/o contrast CT pelvis; with contrast CT pelvis w/o contrast followed by contrast Cervical CT cervical spine; w/o contrast Spine CT cervical spine; with contrast CT cervical spine; w/o contrast followed by contrast Thoracic CT thoracic spine; w/o contrast Spine CT thoracic spine; with contrast CT thoracic spine; w/o contrast followed by contrast Lumbar CT lumbar spine; w/o contrast Spine CT lumbar spine; with contrast CT lumbar spine; w/o contrast followed by contrast Abdomen/Pelvis CT abdomen/pelvis; w/o contrast Combo CT abdomen/pelvis; with contrast CT abdomen/pelvis; w/o contrast followed by contrast No fee schedules, basic units, relative listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. CPT is a trademark of the American Medical Association. 1

2 Computerized Tomography Angiography (CTA) CPT Description Abdomen 74175* CTA abdomen; w/o contrast followed by contrast and 79 further Abdominal Arteries CTA abdominal aorta & bilateral iliofemoral lower extremity runoff; w/o contrast followed by contrast and further Chest CTA chest; w/o contrast followed by contrast and further 75 Upper CTA upper extremity; w/o contrast followed by contrast and Extremity 77 Lower further CTA lower extremity; w/o contrast followed by contrast and Extremity 78 Head further CTA head; w/o contrast followed by contrast and further 72 Neck CTA neck; w/o contrast followed by contrast and further 73 Pelvis CTA pelvis; w/o contrast followed by contrast and further 76 Abdomen/Pelvis Combo CTA abdomen/pelvis; w/o contrast followed by contrast and further Magnetic Resonance Imaging (MRI) CPT Description Abdomen 26 Bone Marrow 30 Breast 29 Chest 25 Cardiac MRI abdomen; w/o contrast MRI abdomen; with contrast MRI abdomen; w/o contrast followed by contrast MRI bone marrow blood supply MRI breast; unilateral MRI breast; bilateral MRI chest; w/o contrast MRI chest; with contrast MRI chest; w/o contrast followed by contrast Cardiac MRI for morphology and function w/o contrast material Cardiac MRI for morphology and function w/o contrast material; with stress imaging Cardiac MRI for morphology and function w/o contrast material(s), followed by contrast material(s) and further sequences Cardiac MRI for morphology and function w/o contrast material(s), followed by contrast material(s) and further sequences; with stress imaging 2

3 Magnetic Resonance Imaging (MRI), continued CPT Description Upper Extremity Non-joint 14 Upper Extremity Any Joint 47 Lower Extremity * MRI upper extremity, other than joint w/o contrast MRI upper extremity, other than joint with contrast MRI upper extremity, other than joint w/o contrast followed by contrast MRI upper extremity, any joint w/o contrast MRI upper extremity, any joint with contrast MRI upper extremity, any joint w/o contrast followed by contrast MRI lower extremity, other than joint w/o contrast MRI lower extremity, other than joint with contrast MRI lower extremity, other than joint w/o contrast followed by contrast MRI lower extremity, any joint w/o contrast MRI lower extremity, any joint with contrast MRI lower extremity, any joint w/o contrast followed by contrast TMJ MRI temporomandibular joint(s) 24 Orbit MRI orbit, face and neck; w/o contrast MRI orbit, face and neck; with contrast MRI orbit, face and neck; w/o contrast followed by contrast Brain MRI brain; w/o contrast MRI brain; with contrast MRI brain; w/o contrast followed by contrast Pelvis MRI pelvis; w/o contrast MRI pelvis; with contrast Cervical Spine 15 Thoracic Spine 16 Lumbar Spine MRI pelvis; w/o contrast followed by contrast MRI cervical spine; w/o contrast MRI cervical spine; with contrast MRI cervical spine; w/o contrast followed by contrast MRI thoracic spine; w/o contrast MRI thoracic spine; with contrast MRI thoracic spine; w/o contrast followed by contrast MRI lumbar spine; w/o contrast MRI lumbar spine; with contrast MRI lumbar spine; w/o contrast followed by contrast 3

4 Magnetic Resonance Angiography (MRA) CPT Description Abdomen 74185* MRA abdomen; with or w/o contrast 33 Chest MRA chest; with or w/o contrast 32 Upper Extremity MRA upper extremity; with or w/o contrast 35 Lower Extremity MRA lower extremity; with or w/o contrast 36 Head MRA head; w/o contrast MRA head; with contrast MRA head; w/o contrast followed by contrast Neck MRA neck; w/o contrast MRA neck; with contrast Pelvis 34 Spinal Canal MRA neck; w/o contrast followed by contrast MRA pelvis; with or w/o contrast MRA spinal canal and contents with or w/o contrast Magnetic Resonance Spectroscopy(MRS) CPT Description MR Spectroscopy Nuclear Cardiology CPT Description Myocardial Perfusion Imaging 19 Infarct Imaging 44 Cardiac Blood Pool Imaging Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic) multiple studies at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic) multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection Planar, infarct avid; qualitative or quantitative Planar, infarct avid; with by first pass technique SPECT, infarct avid; with or w/o quantification Gated equilibrium; planar, single study, wall motion plus Gated equilibrium; planar, multiple studies, wall motion study plus First pass tech; single study, wall motion study plus First pass tech; multiple studies, wall motion study plus Gated equilibrium, SPECT, at rest, wall motion study plus 4

5 Positron Emission Tomography (PET) CPT Description Brain Imaging 42 Myocardial Imaging * PET brain, metabolic evaluation PET brain, perfusion evaluation PET myocardial, metabolic evaluation PET myocardial, perfusion, single study PET myocardial, perfusion, multiple studies CT/PET Fusion CPT Description Tumor Imaging PET tumor imaging, limited PET tumor imaging, skull to mid-thigh PET tumor imaging, whole body PET tumor imaging with concurrent CT, limited PET tumor imaging with concurrent CT, skull to mid-thigh PET tumor imaging with concurrent CT, whole body Screening CT Colonoscopy CPT Description CT colonography, screening, including image postprocessing Diagnostic CT Colonoscopy CPT Description CT colonography, diagnostic, including image postprocessing; without contrast material CT colonography, diagnostic with contrast material(s) including non-contrast images, if performed Functional MRI (fmri) CPT Description Functional MRI NOT REQUIRING physician or psychologist administration Functional MRI REQUIRING physician or psychologist administration 5

6 Echocardiography (stress, resting transthoracic) CPT Description Stress Echocardiography (SE) * Echocardiography, transthoracic, real-time with image documentation (2D), with or w/o M-mode recording, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report Echocardiography, transthoracic, real-time with image documentation (2D), with or w/o M-mode recording, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision CT Heart for Calcium Scoring CPT Description Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium CT Heart for Structure and Morph CPT Description Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed) Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of LV cardiac function, RV structure and function and evaluation of venous structures, if performed) CTA Heart Include Structure and Morph CPT Description Computed tomography angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed) 6