Physician Code Desktop Reference Radiology Diagnostic Center 1310 Las Tablas Road, Ste 103 Templeton P: (805) 434-0829 F: (805) 434-0826 Five Cities Medical Imaging 921 Oak Park Blvd, Ste. 102 Pismo Beach P: (805) 779-7900 F: (805) 779-7910 Digital Medical Imaging 522 East Plaza Drive Santa Maria P: (805) 928-3673 F: (805) 928-9588 Interventional Radiology Services P: (805) 792-0115 * F: (805) 461-5570
WHY THIS GUIDE IS IMPORTANT TO YOU AND YOUR PATIENTS This ordering guide is meant to assist you when ordering a study with Radiology Associates. The guide includes common indications as well as recommendations for the most appropriate exam. It is our goal to provide you and our mutual patients with the most appropriate and complete imaging. After the correct order is placed, exams are further tailored to each patient s specific condition. Thus, it is very important for the radiologist to be aware of the clinical question or specific condition in question so that the appropriate imaging can be performed. It is ideal for us to receive the most recent chart notes relating to the patient s condition or reason for their imaging study in addition to the imaging order. When ordering an examination please include pertinent history as well as signs or symptoms. Please refrain from ordering R/O, Possible, or Suspected exams such as Suspected tear or Rule out anomaly unless history and signs/symptoms are included as well. Feel free to specify a particular entity or condition upon which you would like comment in the report. If you have any questions or concerns, please contact us at one of the numbers listed on the cover of this book. Thank you, The Physicians at Radiology Associates Bone Density Diagnostic Services DMI QCT only FCMI RDC QCT only DX & QCT CT Scan Digital Mammography Fluoroscopy MRI High Field MRI High Field Open Nuclear Medicine PET / CT Imaging Ultrasound X-Ray Interventional Radiology (IR) Services Most procedures performed at SVH or FH. Call IR to coordinate. Abdominal Aortic Aneurysm Abscess / Fluid Drainage Angiography / Angioplasty / Stenting Arterial Disease / Plaque Excision Biliary Interventions Biopsies Dialysis Access DVT Thrombolysis Fibroid Embolization Gastrostomy Tubes Inferior Vena Cava (IVC) Filters Infertility Internal Bleeding Pelvic Congestion Syndrome Peripheral Arterial Disease Spine Interventions / Pain Management Thromobolysis TIPS (Transjugular Intrahepatic Portosystemic Shunt) Varicose Vein / Spider Vein Treatment Vascular Access Vertebroplasty
CT - Computed Tomography CT - Head BODY PART REASON FOR EXAM EXAM TO PRE-CERT Head / Brain Trauma CT Head / Brain 70450 Headaches Without Contrast CVA, Stroke Bleed, Hemorrhage Alzheimer s Memory Loss, Confusion Vertigo, Dizziness Shunt Check Hydrocephalus Metastatic Staging CT Head / Brain 70460 Mass/Tumor With Contrast Infection Headache w/ associated neurologic signs Melanoma CT Head / Brain 70470 HIV Toxoplasmosis Orbits Trauma CT Orbit 70480 Fracture Without Contrast Foreign Body Graves Disease Pseudo Tumor CT Orbit 70481 Pain With Contrast Exopthalmus Abscess Mass CT Orbit 70482 Retinoblastoma Facial Bones Trauma CT Facial Bones 70486 Fracture Without Contrast Cellulitis CT Facial Bones With Contrast 70487 Sinuses Sinusitis CT Sinus Limited 76380 Osteomeatal Complex CT Sinus Complete 70486 Sinusitis Polyps Temporal Hearing Loss, Conductive* CT Inner Ears, Temporal Bones 70480 Bone Cholesteotoma Without Contrst Trauma *Sensory neuro hearing loss, order MRI with and without contrast.
CT - Computed Tomography CT - Head (Continued) BODY PART REASON FOR EXAM EXAM TO PRE-CERT Neck Mass CT Neck 70491 CT- Spine Infection Cancer Workups Parotid Mass With Contrast *If elevated creatinine order without contrast Hoarseness CT Neck 70490 Vocal Chord Paralysis Voice Changes Without Contrast Submandibular Stone CT Soft Tissue Neck 70492 Infection of Submandibular Gland Infection of Parotid Gland Parotid Stone BODY PART REASON FOR EXAM EXAM TO PRE-CERT Cervical Trauma, Fracture, Fusion CT Cervical Spine 72125 Spine Assess Bone Degenerative Changes Without Contrast *MRI recommended for disc herniation, mets, infection Thoracic Trauma, Fracture, Fusion CT Thoracic Spine 72128 Spine Assess Bony Degenerative Changes Without Contrast *MRI recommended for disc herniation, mets, infection Lumbar Trauma, Fracture, Fusion CT Lumbar Spine 72131 Spine Assess Bony Degenerative Changes Without Contrast *MRI recommended for disc herniation, mets, infection Chest F/U nodules CT Chest 71250 Renal Failure Patients Without Contrast Cough CT Chest 71260 Pneumonia With Contrast Lung CA Esophageal CA Lymphoma Lung Nodule Mass Tracheal Stenosis Chest Wall Mass
CT - Computed Tomography CT- Chest BODY PART REASON FOR EXAM EXAM TO PRE-CERT Chest, High Interstitial Disease CT Chest 71250 Resolution Fibrosis Without Contrast COPD Hemoptysis Bronchiectasis Sarcoidosis Pleural Plaques Asbestosis CT- Abdomen & Pelvis BODY PART REASON FOR EXAM EXAM TO PRE-CERT Abdomen F/U for pts with renal cell carcinoma in renal failure (recommend MRI) CT Abdomen Without Contrast 74150 Abdominal Pain (generalized) CT Abdomen 74160 Mass With Contrast RUQ Pain LUQ Pain Epigastric Pain Pseudocyst Pancreatitis Abdomen & Hematuria with Pain CT Abdomen and Pelvis 74176 Pelvis Stone (Stone Study) Without Contrast Abdominal Pain CT Abdomen and Pelvis 74177 Crohns/Ulcerative Colitis/IBD With Contrast Diverticulitis Abscess Mass Hernia (i.e., umbilical, inguinal) Kidney Cyst vs. Mass CT Abdomen Without and 74178 Cancer Staging With Contrast CT Pelvis With Contrast Abdomen Adrenal Mass - No Oral Prep CT Abdomen 74170 (Renal/ Adrenal) Abnormal Ultrasound Renal Mass - No Oral Prep Liver Hemangioma - No Oral Prep (recommend MRI) Hepatitis, Cirrhosis - No Oral Prep
CT - Computed Tomography CT- Abdomen & Pelvis (Continued) BODY PART REASON FOR EXAM EXAM TO PRE-CERT Pelvis Fracture CT Pelvis 72192 Non-Union Prostate Treatment Planning Without Contrast Arthritis CT Pelvis 72193 Cancer Staging Mass Cysts Pain Infection Abscess With Contrast Bone Infection CT Pelvis 72194 (recommend MRI) CT Urogram Transitional Cell Carcinoma of CT Abdomen and Pelvis 74178 (Kidneys/ Bladder) Kidney and/or Bladder With and Without Contrast Defects/Bladder Leakage CT Enteropgraphy Crohns Disease/ CT Abdomen and Pelvis 74177 Inflammatory Bowel Disease Suspected Partial SBO (Small Bowel Obstruction) Small Bowel Masses Celiac Disease With Contrast CT Cystogram Leakage CT Abdomen and Pelvis 74176 Colovesical Fistula With and Without Contrast Virtual Colon Survey CT Abdomen and Pelvis Colonoscopy Failed Colonoscopy Without Contrast CT- Extremities BODY PART REASON FOR EXAM EXAM TO PRE-CERT DIAGNOSTIC 74261 SCREENING 74263 Upper Extremities Fracture CT Upper Extremity 73200 Finger Fusion Without Contrast Hand Non-Union/Malunion Wrist Infection CT Upper Extremity 73201 Forearm Tumor/Mass/Cancer/Mets With Contrast (recommend MRI) Elbow Humerus Shoulder Clavicle Scapula
CT - Computed Tomography CT- Extremities Continued BODY PART REASON FOR EXAM EXAM TO PRE-CERT Sternoclavicular Fracture CT Chest 71250 Joint Non Union/Malunion Without Contrast Lower Extremities Fracture CT Lower Extremity 73700 Foot Fusion Without Contrast Ankle Non-Union/Malunion Calf (Tibia/ Fibula) Arthritis Knee Patello Femoral Malalignment Thigh (Femur) Anteversion/Malrotation (Bilateral) Infection CT Lower Extremity 73701 Tumor/Mass/Cancer/Mets (recommend MRI) With Contrast Leg Lengths Abnormality Leg Length CT Limited 76380 Malrotation XR Bone Length 77073 FAI Protocol Femoral Anteversion for CT Hip Without Contrast AND 72192 FAI Cam Lesion CT Knee Without Contrast 73700 CT- Arthrography BODY PART REASON FOR EXAM EXAM TO PRE-CERT CT Arthrogram Cartilage Abnormality Requires 3 codes: Hip Meniscus Abnormality 1 - Choose upper or lower ext: Knee Labrum Abnormality Lower Extremity With Contrast 73701 Ankle Loose Bodies OR Shoulder Upper Extremity With Contrast 73201 Elbow 2 - Fluoro Guided Arthrogram 77002 Wrist 3 - Choose body part: Hip 27093 Knee 27370 Ankle 27648 Shoulder 23350 Elbow 24220 Wrist 25246 CTA Brain/ Head TIA, CVA CTA Brain 70496 Vascular Malformation Aneurysm AVM (Arterio/ Venous Malformation)
CT - Computed Tomography CT- Angiograpghy (CTA) BODY PART REASON FOR EXAM EXAM TO PRE-CERT CTA Carotid/ Neck Carotid Stenosis CTA Carotid 70498 Bruit TIA, CVA Carotid Dissection CTA Chest Thoracic Aortic Dissection CTA Chest 71275 Thoracic Aortic Aneurysm Coarctation Aortic Root Dilation CTA Chest Chest Pain / Dyspnea CTA Chest 71275 PE Study Tachypnea Shortness of Breath Pulmonary Hypertension (PA HTN) CTA Chest and Thoracic and Abdominal CTA Chest 71275 CTA Abdomen Aortic Dissection CTA Abdomen 72191 * Dissection going past renals Calcium Scoring Calcium Scoring of Coronary Arteries Calcium Score 75571 Fanily History of CAD Aorta, Renal, Stent Aneurysm (AAA) CTA Abdomen and 74175 Stent Obstruction/Leak/Malfunction CTA Pelvis 72191 Crossing Vessels Anatomic Marking for Partial/ Complete Nephrectomy Renal Artery Stenosis CTA Upper Trauma CTA Upper Extremity 73206 Extremities Arterial Stenosis CTA Upper Peripheral Artery Disease CT Lower Extremity 73706 Extremities Ischemia to Lower Extremity Arterial Stenosis CTA Run-Off Peripheral Artery Disease (PAD) CTA Abdomen, Pelvis, Bilateral 75635 Ischemia to Lower Extremity Arterial Stenosis Lower Extremities
MRI - Magnetic Resonance Imaging MRI- Head & Neck BODY PART REASON FOR EXAM PROCEDURE TO PRE-CERT Brain Alzheimer s, Dementia, Memory Loss MRI Brain 70551 Mental Status Changes, Confusion Headache Without Focal Symptoms Seizures (children) Stroke, CVA, TIA Trauma Without Contrast Cranial Nerve Lesions MRI Brain 70553 Dizziness, Vertigo Headache With Focal Symptoms HIV IAC/Hearing Loss Infection Multiple Sclerosis Neurofibromatosis Pituitary Lesion, Elevated Prolactin Seizures (adult new onset) Tumor / Mass / Cancer / Mets Vascular Lesions Vision Changes Trigeminal Neuralgia Order 2 exams: MRI Brain 70553 MRI Orbits / Face / Neck 70543 Orbits Grave s Disease MRI Orbits / Face / Neck 70540 Trauma Without Contrast Exopthalmos, Proptosis MRI Orbits / Face / Neck 70543 Pseudotumor Tumor / Mass / Cancer / Mets Vascular Lesions Optic Neuritis Neck Infection MRI Orbits/Face/Neck 70543 Pain Tumor / Mass / Cancer / Mets Vocal Cord Paralysis Parotid Gland MRI Orbits/Face/Neck 70543
MRI - Magnetic Resonance Imaging MRI- Spine BODY PART REASON FOR EXAM PROCEDURE TO PRE-CERT Cervical Arm / Shoulder Pain or Weakness MRI Cervical Spine 72141 Degenerative Disease Neck Pain Disc Herniation Without Contrast Cervical Fusion Radiculopathy Discitis MRI Cervical Spine 72156 Osteomylitis Multiple Sclerosis Myelopathy Syrinx Tumor / Mass / Cancer / Mets Vascular Lesions, AVM Thoracic Back Pain MRI Thoracic Spine 72146 Compression Fx (no hx cancer) Degenerative Disease Disc Herniation Radiculopathy Trauma Without Contrast Compression Fx (with hx cancer) MRI Thoracic Spine 72157 Discitis Osteomylitis Multiple Sclerosis Myelopathy Syrinx Tumor / Mass / Cancer / Mets Vascular Lesions AVM Lumbar Back Pain MRI Lumbar Spine 72148 Compression Fx (no hx malig / mets) Degenerative Disease Disc Herniation Radiculopathy Sciatica Spondylolithesis Stenosis Trauma Without Contrast Compression Fx (no hx malig / mets) MRI Lumbar Spine 72158 Discitis Osteomylitis Tumor / Mass / Cancer / Mets
MRI - Magnetic Resonance Imaging MRI- Chest / Abdomen / Pelvis BODY PART REASON FOR EXAM PROCEDURE TO PRE-CERT Brachial Brachial Plexus Injury MRI Chest 71552 Plexus Nerve Avulsion MRI Neck 70543 Tumor / Mass / Cancer / Mets (Please authorize BOTH codes.) Chest- Tumor / Mass / Cancer / Mets MRI Chest / Mediastinum 71552 Mediastinum Breast Implant Rupture MRI Bilateral Breast Without Contrast 77059 Abnormal Mammogram MRI Bilateral Breast 77059 Abnormal Ultrasound Dense Breast/High Risk Mass / Lesion / Cancer Palpable Mass Abdomen MRCP (Biliary / Pancreatic Ducts) MRI Abdomen Without Contrast 74181 Adrenal Adenoma MRI Abdomen 74183 Adrenal Mass (not adenoma) Hemangioma Liver, Kidney, or Pancreas Mass Tumor / Mass / Cancer / Mets Pelvis Adenomyosis MRI Pelvis Without Contrast 72195 Fracture Muscle / Tendon Tear Urethral Diverticulum Sports Hernia Fibroids MRI Pelvis 72197 Osteomylitis Septic Arthritis Tumor / Mass / Cancer / Mets Abcess Ulcer MRI- Enterography Abdomen & Pelvis BODY PART REASON FOR EXAM PROCEDURE TO PRE-CERT Abdomen Crohns Disease/Inflammatory Order 2 Exams: Pelvis Bowel Disease MRI Abdomen 74183 GI Bleed Suspected Partial SBO MRI Pelvis 72197 (Small Bowel Obstruction) Small Bowel Masses Celiac Disease
MRI - Magnetic Resonance Imaging MRI- Extremities BODY PART REASON FOR EXAM PROCEDURE TO PRE-CERT Non-Joint: Fracture MRI Non Joint Without Contrast Arm Stress Fracture Lower Extremity 73718 Hand Muscle / Tendon Tear Upper Extremity 73218 Finger Abcess MRI Non Joint Without and With Leg Ulcer I.V. Contrast Foot Bone Tumor / Mass / Cancer / Mets Lower Extremity 73720 Toe Cellulitis Upper Extremity 73220 Fasciitis Myositis Morton s Neuroma Osteomylitis Soft Tissue Tumor / Mass / Cancer Joint: Arthritis MRI Joint Without Contrast Shoulder Avascular Necrosis (AVN) Lower Extremity 73721 Elbow Fracture Upper Extremity 73221 Wrist Stress Fracture Hip Internal Derangement Knee Joint Pain (specify joint) Ankle Labral Tear Meniscal Tear Muscle Tear Tendon Tear Ligament Tear Cartilage Tear Osteochondritis Dessicans (OCD) Abcess MRI Joint Without and With Ulcer I.V. Contrast Cellulitis Lower Extremity 73723 Fasciitis Upper Extremity 73223 Myositis Inflammatory Arthritis (pannus eval) Osteomylitis Septic Arthritis Tumor / Mass / Cancer / Mets
MRI - Magnetic Resonance Imaging MRI- Arthrography Joints BODY PART REASON FOR EXAM PROCEDURE TO PRE-CERT Shoulder Labral Tear MRI Joint With Intra-articular Contrast Elbow Loose Bodies Wrist OCD Stability Requires 3 codes: Hip Post-op Meniscus Evaluation 1 Lower Extremity With Contrast OR 73722 Knee Upper Extremity With Contrast 73222 Ankle 2 Fluoro Guided Arthrogram 77002 3 Choose one code for body part: Shoulder 23350 Elbow 24220 Wrist 25246 Hip 27093 Knee 27370 Ankle 27648 MRA / MRV- MR Angiography / MR Venography BODY PART REASON FOR EXAM PROCEDURE TO PRE-CERT Head (MRA) Stroke, CVA, TIA MRA Head Without Contrast 70544 Aneurysm Head (MRV) Venous Thrombosis MRV Head Without Contrast 70544 Neck Stroke, CVA, TIA MRA Neck Without Contrast 70547 Dissection MRA Neck 70549 Chest Thoracic Aorta MRA Chest 71555 (other than dissection) Vascular Anomalies Subclavian Vessels Aortic Dissection Order 2 Exams: MRA Chest 71555 MRA Abdomen 74185 Arch & Great Stroke, CVA, TIA MRA Neck 70549 Vessels Abdomen AAA (abdominal aortic aneurysm) MRA Abdomen 74185 (MRA) Abdominal Aortic Dissection Mesenteric Ischemia Pre Kidney Transplant Renal Mass Order 2 Exams: Uncontrolled Blood Pressure MRA Abdomen 74185 MRI Abdomen 74183
MRI - Magnetic Resonance Imaging MRA / MRV- MR Angiography / MR Venography BODY PART REASON FOR EXAM PROCEDURE TO PRE-CERT Abdomen Venous Thrombosis MRV Abdomen 74185 (MRV) Venous Pathology Pelvis AVM (arteriovenous malformation) MRA Pelvis 72198 Pelvic Congestion Order 2 Exams: MRA Pelvis 72198 MRI Pelvis 72197 Peripheral Claudication Requires 3 codes: Run-Off Cold Foot MRA Abdomen 74185 Pain MRA Lower Extremity 73725 (Left) MRA Lower Extremity 73725 (Right)
Nuclear Medicine Nuclear Medicine- Bone Scan COMMON INDICATIONS S Primary or metastatic tumors initial evaluation or follow-up of therapy Total body 78306 Pain of suspected musculoskeletal etiology Multi-area 78305 Paget s disease 3-phase 78315 Stress or occult fractures Bone SPECT 78320 Trauma Limited Area 78300 Osteomyelitis or musculoskeletal inflammation Bone viability grafts or avascular necrosis (AVN) Metabolic bone disease Arthritities Prosthetic joint evaluation for loosening or infection Evaluation of abnormal findings by other imaging modalities Evaluation of abnormal lab findings, especially elevated alkaline phosphatase Reflex sympathetic dystrophy (RSD) Suspected Charcot s joint Nuclear Medicine- Biliary Scan COMMON INDICATIONS S Right upper quadrant or abdominal pain Biliary 78223 Gallstones on CT or ultrasound Biliary with CCK 78223 Evaluation of gallbladder ejection fraction i.e., CCK Biliary Assessment of liver transplant function Evaluation of biliary atresia in pediatric patients Evaluation of bile leak Evaluation of common bile duct obstruction Evaluation of choledochal cyst Nuclear Medicine- Gallium Scan COMMON INDICATIONS S Evaluation of fevers of unknown origin Total body 78806 Disk space or joint space infection Limited area 78805 Evaluation of infection in immuno-compromised individuals SPECT 78803 Osteomylitis (Bone Gallium) Infection of prosthetic joints Detection of inflammatory disease such as sarcoid and tuberculosis. Evaluation of vascular graft infection Abscess localization Evaluation of pulmonary inflammation due to drug/environmental reaction, e.g., Amiodarone toxicity Polynephritis Post-operative surgical incision site infection Evaluation of inflammatory bowel disease Evaluation of diabetic ulcers
Nuclear Medicine Nuclear Medicine- Gastric Emptying Scan COMMON INDICATIONS S Abdominal pain 78264 Gastro-esophageal reflux Vomiting Gastroparesis/Diabetics Weight loss Feeling of fullness Nuclear Medicine- Indium & Ceretec WBC Scan COMMON INDICATIONS Evaluation of fevers of unknown origin Disk space or joint space infection Evaluation of infection in immunocompromised individuals Osteomylitis Infection of prosthetic joints Evaluation of vascular graft infection Abscess localization Post-operative surgical incision site infection Evaluation of inflammatory bowel disease Evaluation of diabetic ulcers Note: Indium is a better choice for ortho patients with hardware. S 78805 for both Nuclear Medicine- Lung (VQ) Scan COMMON INDICATIONS S The assessment of the probability of acute or chronic pulmonary VQ scan 78585 thromboembolic disease VQ QUANT 78596 The establishment of the presence of chronic, unresolved pulmonary emboli The quantification of differential pulmonary function The evaluation of lung transplants The evaluation of the effects of congenital heart/lung disease The confirmation of the presence of bronchopleural fistulae The evaluation of effects of chronic pulmonary parenchymal disorders such as cystic fibrosis Nuclear Medicine- Parathyroid Scan COMMON INDICATIONS S Parathyroid adenoma 78070 Increased PTH levels Hypercalcemia
Nuclear Medicine Nuclear Medicine- Renal Scan COMMON INDICATIONS S Urinary tract obstruction DTPA or MAG3 78707 Evaluate renal function Captopril renal 78709 Renal vascular disease Renal with Lasix 78708 Polycystic kidney disease DMSA renal 78700 Post transplant evaluation Pyelonephritis Parenchymal scarring Nuclear Medicine- Thyroid Scan and Uptake COMMON INDICATIONS S Assessment of size and location of thyroid tissue Thyroid scan only Evaluation of thyroid masses 78013 Abnormal thyroid lab results (Hyperthyroidism / Hypothyroidism) Thyroid uptake and scan Differentiation of hyperthyroidism/thyroiditis 78014 Abnormal weight gain or weight loss I123 Thyroid uptake and scan Cardiac arrythmia 78014 Nuclear Medicine- I-131 Whole Body Scan COMMON INDICATIONS S Evaluation and treatment of thyroid carcinoma 78018 Hyperthyroidism
Ultrasound Ultrasound- Neck BODY PART REASON FOR EXAM PREP Soft Tissues Mass None 76536 Neck (Thyroid), Abnormalities detected on other imaging Head / Face (CT / MRI / PET / NM) Enlarged thyroid gland Multinodular goiter (MNG) Abnormal lab tests (elevated calcium levels / abnormal thyroid level) Parathyroid adenomas Hyperthyroidism / Hypothyroidism Carotid Artery Weakness None 93880 Headache Syncope Hemiplegia Difference in arm blood pressure Aphasia Ataxia Reversible ischemic neurological deficit (RIND) Bruit Vertigo / dizziness (non medicare) Memory loss (non medicare) Dementia (non medicare) Transient ischemic attack (TIA) Confusion Stroke Visual disturbance Cerebrovascular accident (CVA) Amaurosis fugax Ultrasound- Chest BODY PART REASON FOR EXAM PREP Chest Diaphragm paralysis None 76604 Pleural effusion Superficial mass Aorta Aortic aneurysm (follow up to AAA) NPO 6 hours prior 76775 (Limited Pulsatile aorta to exam Retroperitoneal) Bruit Family history AAA (non medicare)
Ultrasound Ultrasound- Abdomen BODY PART REASON FOR EXAM PREP Abdomen Cirrhosis or hepatic disease NPO 6 hours prior 76700 Complete (Hepatitis / Portal Hypertension) to exam Abdominal distention (fluid collection) ascites Pain (Abdominal / Epigastric / Periumbilical) Nausea / Vomiting Gallstones Obstructive symptoms of the biliary system (Jaundice) Abnormal diagnostic tests (CT / MR) Gastroesophageal reflux (GERD) Splenomegaly Abnormal liver functions (Elevated LFT s / Fatty liver) Hepatomegaly Abdomen * all of the above NPO 6 hours prior 76705 Limited to exam Abdomen Cirrhosis or hepatic disease (hepatitis/ NPO 6 hours prior 93975 Doppler portal hypertension) to exam 93976 (Vascular) Ascites Varices Portal vein thrombosis Budd-Chiari Syndrome Intrahepatic Portosystemic Venous Shunts TIPS Hepatomegaly Splenomegaly Ultrasound- Pelvis BODY PART REASON FOR EXAM PREP Pelvis Pain (pelvic or adnexal tenderness) Pelvis Complete 76856 Ovarian cyst Transvaginal 76830 Uterine fibroids Enlarged uterus or ovary (mass) *Please note: An Us Pelvis Complete is a Transabdominal exam. If a Transvaginal Us is needed it must be specifically Adnexal abnormalities indicated. Dysfunctional uterine bleeding Post menopausal bleeding Precocious puberty Polycystic ovary Disease (PCOD) Fill bladder with 32 oz of water 1/2 hour prior to exam. Do not void. Ovarian follicle monitoring Pelvic Doppler Ovarian torsion/pelvic pain Fill bladder with 32 oz 93975 Follow up fibroid embolization of water 1 hour prior 93976 Ovarian vein embolization Evaluation of pelvic congestion syndrome (PCS) to exam. Do not void. Transvaginal Only: No prep
Ultrasound Ultrasound- Pelvis BODY PART REASON FOR EXAM PREP Scrotum Pain 76870 Trauma Torsion Mass Varicocele Epididymitis Hydrocele (swelling) Undescended testes Ultrasound- Retroperitoneal BODY PART REASON FOR EXAM PREP Kidney (renal) Pain (CVA tenderness/flank pain) Only for bladder: 76770 and Bladder Obstruction (hydronephrosis) Fill bladder with 32 oz Hypertension Follow up to other diagnostic imaging test (CT or MRI) Abnormal lab values (BUN or Creatinine) Stones (renal) Chronic renal medical disease (renal function/ renal failure) Polycystic kidney disease (PCKD) Urinary tract infection/cystitis/pyelonephritis Renal cancer Trauma Hematuria (microscopic or gross) Neurogenic bladder Urinary retention - Evaluate post void residual (PVR) of water 1/2 hour prior to exam. Do not void. Bladder diverticula Renal Transplant Post renal transplant None 76776 Urinoma Lymphocele Pain Elevated lab values (creatinine) Poor renal function Renal Doppler Renal artery stenosis NPO 6 hours prior 93975 Renal artery aneurysm to exam 93976 Renal vein thrombosis Hypertension Abnormal laboratory values (elevated creatinine/bun)
Ultrasound Ultrasound- Extremities/ Musculoskeletal BODY PART REASON FOR EXAM PREP Upper or Lower Pain None 76881 Extremity Fluid collection (Bakers Cyst) Limited Complete (non Doppler) Mass Limited Musculoskeletal Biceps tendon/rotator cuff exams (MSK radiologist 76882 needs to perform - Book w/jris) Complete Biceps tendon scan with injection Bakers cyst aspiration with injection Limited Joints/shoulder/elbow/ankle/knee ultrasound Upper or Lower Edema/swelling None 93965 Extremity Venous Calf pain (non medicare) 93970 Doppler Post surgical (non medicare) 93971 Redness Follow up DVT Positive Homan sign (shooting pain with foot dorsiflexion) History long plane/car trip Upper or Lower Claudication/pain with walking None 93922 Extremity Arterial Decreased or absent pulses 93923 Doppler (PVR) Arthrosclerosis 93924 Duplex Bruit None 93925 High risk family history (non medicare) 93926 Numbness (non medicare) 93930 S/P graft or stenting 93931 Ulcer on foot or toe (non medicare) Discoloration of feet or legs (non medicare) Thoracic outlet syndrome Decrease arm pressure Cold fingers or toes (poor circulation) Venous Reflux Edema/swelling None 93965 Leg ulcer (non medicare) Pain (non medicare) Venous insufficiency Varicose veins Burning or tingling (non medicare) Phlebitis/Thrombophlebitis Arterial Screening Carotid None 76999 Aorta ABI (ankle brachial indices)
Flouroscopy Flouroscopy EXAM PREP SPECIAL INSTRUCTIONS IR Lumbar Epidural (Includes FL Guidance 77003) 62311 Myelogram (Includes Intrathecal Injection 62284) - Thoracic None Schedule in morning first and CT to follow 72255 Needs Recovery Time, Needs Driver Myelogram (Includes Intrathecal Injection 62284) - Lumbar None Schedule in morning first and CT to follow 72265 Needs Recovery Time, Needs Driver Esophogram - Contrast XR w/ Barium NPO 8 hrs prior to exam Schedule in morning 74220 Swallowing Function - Contrast XR w/ Barium NPO 4 hrs prior to exam 74230 UGI (Upper Gastrointestinal) NPO 8 hrs prior to exam 74240 UGI with KUB 74241 UGI with SBFT 74245 UGI with Air 74246 UGI with Air and KUB 74247 UGI with Air and SBFT 74249 SBFT (Small Bowel Follow Thru) NPO after midnight Schedule at 8:30 (may take 4 hrs) 74250 Hypotonic Duodenography 74260 BE (Barium Enema) with or without KUB Pick up BE Prep kit 2 days prior 74270 BE with Air Pick up BE Prep kit 2 days prior 74280 IVP No food 2 hrs prior to exam. Patient can drink. 74400 Cystourethrogram - Retrograde 74450 Cystourethrogram - Voiding (VCUG) None Patient needs to arrive pre-cathed 74455 Must be done between the 7th - 10th day following the start of the patient's menstrual cycle. Hysterosalpinogram (HSG) (Includes cpt 58340) No sexual contact once period has started until after Schedule 7th- 10th day following first day of 74740 procedure. menstrual cycle Venogram - Extremity Unilateral (Includes Injection 36005) 75820 Venogram - Extremity Bilateral (Includes Injection 36005) 75822 Arthrogram None Schedule MRI or CT to follow FL Guided Lumbar Puncture Hydrate well day before exam Schedule morning exam before 10 am Patient needs a driver FL Guided Needle Placement FL Guided Picc Placement None None FL Guided Port Study None Tunneled ports need to come pre-accessed SNIFF Test
X-Rays X rays EXAM PREP SPECIAL INSTRUCTIONS Chest 1 View schedule s/p Thoracentesis Chest 2 View 71020 Lumbar Spine 2-3 Views 72100 Lumbar Spine includes bending views; only 2 or 3 views 72120 Lumbar Spine Complete includes bending views; minimum of 6 views 72114 Abdomen (KUB) 1 View 74000 Thoracic 3 View 72072 Cervical 2-3 Views 72040 Sinus less than 3 Views 70210 Pelvis 1-2 Views 72170 Shoulder minimum 3 Views 73030 Elbow minimum 3 Views 73080 Forearm 2 Views 73090 Wrist 2 Views 73100 Hand 2 Views 73120 Fingers minimum 3 Views 73140 Hip minimum 2 Views 73510 Ankle 2 View 73600 Foot 2 View 73620 Toes minimum 2 Views 73660 Small Intestines 74250