26 CPT Radiology, ECHO, and PET Codes Requiring Review (Please Note: Group # and Default CPT "" are for internal claims processing use only) Modality Body Part Default CPT "" CT Head 748 CT orbit, sella or posterior fossa; w/o contrast CT Head 748 CT orbit, sella or posterior fossa; wit contrast CT Head 7482 CT orbit, sella or posterior fossa; w/o contrast followed by contrast CT Head 2 7486 CT maxillofacial area (sinus); w/o contrast CT Head 2 7487 CT maxillofacial area (sinus); wit contrast CT Head 2 7488 CT maxillofacial area (sinus); w/o contrast followed by contrast CT Head 3 745 CT ead or brain; w/o contrast CT Head 3 746 CT ead or brain; wit contrast CT Head 3 747 CT ead or brain; w/o contrast followed by contrast CT Neck 4 749 CT soft tissue neck; w/o contrast CT Neck 4 749 CT soft tissue neck; wit contrast CT Neck 4 7492 CT soft tissue neck; w/o contrast followed by contrast CT Cest 5 725 CT torax; w/o contrast (noncardiac) CT Cest 5 726 CT torax; wit contrast (noncardiac) CT Cest 5 727 CT torax; w/o contrast followed by contrast (noncardiac) CT Abdomen 6 745 CT abdomen; w/o contrast CT Abdomen 6 746 CT abdomen; wit contrast CT Abdomen 6 747 CT abdomen; w/o contrast followed by contrast CT Pelvis 7 7292 CT pelvis; w/o contrast CT Pelvis 7 7293 CT pelvis; wit contrast CT Pelvis 7 7294 CT pelvis; w/o contrast followed by contrast CT Spine 8 7225 CT cervical spine; w/o contrast CT Spine 8 7226 CT cervical spine; wit contrast CT Spine 8 7227 CT cervical spine; w/o contrast followed by contrast CT Spine 9 7228 CT toracic spine; w/o contrast CT Spine 9 7229 CT toracic spine; wit contrast CT Spine 9 723 CT toracic spine; w/o contrast followed by contrast CT Spine 723 CT lumbar spine; w/o contrast CT Spine 7232 CT lumbar spine; wit contrast CT Spine 7233 CT lumbar spine; w/o contrast followed by contrast CT Extremity 732 CT upper extremity; w/o contrast CT Extremity 732 CT upper extremity; wit contrast CT Extremity 7322 CT upper extremity; w/o contrast followed by contrast CT Extremity 2 737 CT lower extremity; w/o contrast CT Extremity 2 737 CT lower extremity; wit contrast CT Extremity 2 7372 CT lower extremity; w/o contrast followed by contrast MRI Head 3 755 MRI brain; w/o contrast MRI Head 3 7552 MRI brain; wit contrast MRI Head 3 7553 MRI brain; w/o contrast followed by contrast MRI Extremity 4 7328 MRI upper extremity, oter tan joint w/o contrast MRI Extremity 4 7329 MRI upper extremity, oter tan joint wit contrast MRI Extremity 4 7322 MRI upper extremity, oter tan joint w/o contrast followed by contrast MRI Spine 5 724 MRI cervical spine; w/o contrast MRI Spine 5 7242 MRI cervical spine; wit contrast MRI Spine 5 7256 MRI cervical spine; w/o contrast followed by contrast MRI Spine 6 7246 MRI toracic spine; w/o contrast MRI Spine 6 7247 MRI toracic spine; wit contrast MRI Spine 6 7257 MRI toracic spine; w/o contrast followed by contrast MRI Spine 7 7248 MRI lumbar spine; w/o contrast MRI Spine 7 7249 MRI lumbar spine; wit contrast MRI Spine 7 7258 MRI lumbar spine; w/o contrast followed by contrast MRI Heart 8 75557 MRI Cardiac for morpology and function witout contrast material; MRI Heart 8 75559 MRI Cardiac for morpology and function witout contrast material; wit stress imaging 92 (-25)
MRI Heart 8 7556 MRI Cardiac for morpology and function witout contrast material(s), followed by contrast material(s) and furter sequences; MRI Heart 8 75563 MRI Cardiac for morpology and function witout contrast material(s), followed by contrast material(s) and furter sequences; wit stress imaging NUC Card Heart 9 7845 Myocardial perfusion SPECT single study including qualitative or quantitative wall motion, by st pass or gated tecnique, rest or stress NUC Card Heart 9 78452 Myocardial perfusion SPECT multiple studies including qualitative or quantitative wall motion, by st pass or gated tecnique, rest NUC Card Heart 9 78453 Myocardial perfusion planar single study including qualitative or quantitative wall motion, by st pass or gated tecnique, rest or stress NUC Card Heart 9 78454 Myocardial perfusion planar multiple studies including qualitative or quantitative wall motion, by st pass or gated tecnique, rest and/or stress MRI Head 23 754 MRI orbit, face and neck; w/o contrast MRI Head 23 7542 MRI orbit, face and neck; wit contrast Modality Body Part Default CPT "" MRI Head 23 7543 MRI orbit, face and neck; w/o contrast followed by contrast MRI Head 24 7336 MRI temporomandibular joint(s) MRI Cest 25 755 MRI cest; w/o contrast MRI Cest 25 755 MRI cest; wit contrast MRI Cest 25 7552 MRI cest; w/o contrast followed by contrast MRI Abdomen 26 748 MRI abdomen; w/o contrast MRI Abdomen 26 7482 MRI abdomen; wit contrast MRI Abdomen 26 7483 MRI abdomen; w/o contrast followed by contrast MRI Pelvis 27 7295 MRI pelvis; w/o contrast MRI Pelvis 27 7296 MRI pelvis; wit contrast MRI Pelvis 27 7297 MRI pelvis; w/o contrast followed by contrast MRI Breast 29 7758 MRI pelvis; Unilateral /27/4 MRI Breast 29 7759 MRI pelvis; Bi lateral /27/4 MRI Oter 3 7784 MRI bone marrow blood supply MRA Head 3 7544 MRA ead; w/o contrast MRA Head 3 7545 MRA ead; wit contrast MRA Head 3 7546 MRA ead; w/o contrast followed by contrast MRA Cest 32 7555 MRA cest; wit or w/o contrast MRA Abdomen 33 7485 MRA abdomen; wit or w/o contrast MRA Pelvis 34 7298 MRA pelvis; wit or w/o contrast MRA Extremity 35 73225 MRA upper extremity; wit or w/o contrast MRA Extremity 36 73725 MRA lower extremity; wit or w/o contrast MRA Spine 37 7259 MRA spinal canal and contents wit or w/o contrast CT Oter 4 7778 CT bone mineral density study; axial skeleton NUC Card Heart 44 78466 Planar, infarct avid; qualitative or quantitative NUC Card Heart 44 78468 Planar, infarct avid; wit by first pass tecnique NUC Card Heart 44 78469 SPECT, infarct avid; wit or w/o quantification MRI Extremity 46 7378 MRI lower extremity, oter tan joint w/o contrast MRI Extremity 46 7379 MRI lower extremity, oter tan joint w contrast MRI Extremity 46 7372 MRI lower extremity, oter tan joint w/o contrast followed by contrast MRI Extremity 46 7372 MRI lower extremity, any joint w/o contrast MRI Extremity 46 73722 MRI lower extremity, any joint w contrast MRI Extremity 46 73723 MRI lower extremity, any joint w/o contrast followed by contrast MRI Extremity 47 7322 MRI upper extremity, any joint w/o contrast MRI Extremity 47 73222 MRI upper extremity, any joint wit contrast 92 (-25)
MRI Extremity 47 73223 MRI upper extremity, any joint w/o contrast followed by contrast CTA Head 72 7496 CTA ead CTA Neck 73 7498 CTA neck MRA Neck 74 7547 MRA neck; w/o contrast MRA Neck 74 7548 MRA neck; wit contrast MRA Neck 74 7549 MRA neck; w/o contrast followed by contrast CTA Cest 75 7275 CTA cest (noncoronary) CTA Pelvis 76 729 CTA pelvis CTA Extremity 77 7326 CTA upper extremity CTA Extremity 78 7376 CTA lower extremity CTA Abdomen 79 7475 CTA abdomen CTA Abdomen 23 75635 CTA abdominal aorta & bilateral iliofemoral lower extremity runoff CTA Abd/Pelvis 22 7474 CTA Abdomen & Pelvis MRI Oter 8 7639 MR Spectroscopy /27/4 NUC Card Heart 82 78472 Cardiac blood pool, gated equilibrium; planar, single study, wall motion plus NUC Card Heart 82 78473 Cardiac blood pool gated equilibrium; planar, multiple studies, wall motion study plus NUC Card Heart 82 7848 Cardiac blood pool first pass tec; single study, wall motion study plus ejection fraction NUC Card Heart 82 78483 Cardiac blood pool first pass tec; multiple studies, wall motion study plus NUC Card Heart 82 78494 Cardiac blood pool gated equilibrium, SPECT, at rest, wall motion study plus ECHOCARDIOGRAPHY CODES - EFFECTIVE 2/9/23 WA&OR, EFFECTIVE //25 ALASKA Default Stress Eco CPT "" Heart 93 9335 toracic Stress Eco, complete 2/9/23 AK Eff (SE) Stress Eco Heart 93 9335 2/9/23 AK Eff Heart 94 9333 2/9/23 AK Eff toracic Eco cardiac anomalies toracic Stress Eco, complete w cont EKG Modality Body Part Default CPT "" Heart 94 9334 WA, OR AK Eff toracic Eco cardiac anomalies, limited /5 Heart 94 9336 2/9/23 AK Eff Heart 94 9337 2/9/23 AK Eff toracic Eco complete w color & spectral toracic Eco complete wo color & spectral Heart 94 9338 2/9/23 AK Eff toracic Eco limited 92 (-25)
9332 2/9/23 AK Eff ageal Eco 9333 2/9/23 AK Eff ageal Eco probe only 9334 2/9/23 AK Eff ageal Eco interpretation 9335 2/9/23 AK Eff ageal Eco congenital 9336 2/9/23 AK Eff ageal Eco congenital, probe only 9337 2/9/23 AK Eff ageal Eco congenital interpretation Eco Add- Heart 9332 Doppler Eco complete Eco Add- Heart 9332 Doppler Eco limited Eco Add- Heart 93325 Doppler Eco flow velocity Eco Add- Heart 93352 Eco contrast agent (SE only) group 93 O Default CPT "" PET Head 42 7868 PET brain, metabolic evaluation PET Head 42 7869 PET brain, perfusion evaluation PET Heart 7 78459 PET myocardial, metabolic evaluation PET Heart 7 7849 PET myocardial, perfusion, single study PET Heart 7 78492 PET myocardial, perfusion, multiple studies PET Oter 84 788 PET tumor imaging, limited Modality Body Part Default CPT "" PET Oter 84 7882 PET tumor imaging, skull to mid-tig PET Oter 84 7883 PET tumor imaging, wole body PET Oter 84 7884 PET tumor imaging wit concurrent CT, limited PET Oter 84 7885 PET tumor imaging wit concurrent CT, skull to mid-tig PET Oter 84 7886 PET tumor imaging wit concurrent CT, wole body CT Oter 85 74263 Eff Computed Tomograpic (CT) Colonagrapy, screening, including image postporcessing /27/4 CT Oter 86 7426 eff /27/24 Computed Tomograpic (CT) Colonagrapy,diagnostic, including image postprocessing; witout contrast material CT Oter 86 74262 Eff /27/24 Computed Tomograpic (CT) Colonagrapy,diagnostic, including image postprocessing; witout contrast material(s) including non-contrast images, if performed 92 (-25)
MRI Head 88 7554 Eff /27/24 MRI Head 88 7555 Eff /27/24 Functional MRI brain not requiring pysician or psycologist Functional MRI brain requiring pysician or psycologist CT Heart 98 7557 Eff /27/24 Computed Tomograpic, eart, witout contrast material, wit quantitive evaluation of coronay calcium CT Heart 99 75572 Eff /27/24 CT Heart 99 75573 Eff /27/24 Computed Tomograpic, eart, wit contrast material, for evaluation of cardiac structure and morpology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed) Computed Tomograpic, eart, wit contrast material, for evaluation of cardiac structure and morpology in te setting of congenital ear disease (including 3D image postprocessing, assessment of LV cardiac function, RV structure and function and evaluation of venous structures, is performed) CT Heart 75574 Eff /27/24 Computed tomograic angiogray, eart, coronary arteries and bypass graft(wen present), wit contrast material, including 3D image postprocessing including evaluation of cardiac structure and morpology, assessment of cardiac function, and evaluation of venous structures, if performed) CT Abd/Pelvis 7476 CT Abdomen & Pelvis witout contrast CT Abd/Pelvis 7477 CT Abdomen & Pelvis wit contrast CT Lung 2 S832 Low Dose CT Lung Cancer Screening (COMMERCIAL LOB) CT Abd/Pelvis 7478 CT Abdomen & Pelvis wo/w contrast MRI Cest 9 G297 Eff Low Dose CT Lung Cancer Screening 2/3/24 MRI Pelvis 2 7472 MRI Fetal 92 (-25)