Clinician s Guide To Ordering NeuroImaging Studies

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Clinician s Guide To Ordering NeuroImaging Studies"

Transcription

1 Clinician s Guide To Ordering NeuroImaging Studies MRI CT

2 South Jersey Radiology Associates The purpose of this general guide is to assist you in choosing the appropriate imaging test to best help your patient. It is organized by test name with common indications. There are special protocols for some specific indications which are also listed. General guidelines about whether or not contrast is helpful and should be ordered are also included. Please know that all patients symptoms may not fit a specific protocol, and sometimes can overlap more than one protocol. When possible, we attempt to tailor each study to the specific clinical indication. In that regard, the more details and specificity that you provide in the prescription, the better we can protocol the examination to answer the clinical question. If you do have any questions about which study to order, how to order, or whether contrast would be helpful, please do not hesitate to call one of our radiologists. We appreciate your trust and the opportunity to participate in your patient s care. South Jersey Radiology Associates

3 DO I NEED TO ORDER CONTRAST? General principles MRI If the patient s GFR is below 30, contrast should not be given The patient will need blood work for renal function studies within 3 months if there is a history of diabetes or kidney surgery and within 6 months if the patient is over 70 with no other renal risk factors. MRIs ordered with IV contrast should be ordered, WITHOUT AND WITH CONTRAST CT CTs in general should be ordered either WITHOUT CONTRAST OR WITH CONTRAST, not both, to minimize radiation *In general, all CTs should be ordered either WITHOUT CONTRAST OR WITH CONTRAST, not both. *For MRI, anyone with a history of cancer or suspected metastases, should have an MRI WITHOUT AND WITH CONTRAST. *If MRI is contraindicated, CT of the appropriate anatomy can be considered.

4 Common Examinations Choice of examinations (Specify without contrast OR without and with contrast ). Please note that this is not an all-inclusive list; if you need an imaging protocol not listed, please specify what you would like on the prescription with a detailed history and we will generate an appropriate protocol. Please do not hesitate to contact us if you have any questions. MRI CT Specify EITHER without contrast OR without and with contrast Specify EITHER without contrast OR with contrast only MRI brain Routine MRI brain Memory loss MRI brain Memory loss with 3D Neuroquant MRI brain Orbit MRI brain Internal auditory canal (IAC) MRI brain Pituitary/sella MRI brain Skull base MRI brain Multiple sclerosis MRI brain Face/Paranasal sinus MRI brain Seizure/epilepsy MRI brain Trigeminal neuralgia MRI neck CT brain CT sinus - Routine CT sinus - Landmarx/Stryker (surgical planning) CT orbits CT facial bones CT mandible CT pituitary (if MRI contraindicated) CT temporal bones/iacs CT cervical spine CT thoracic spine CT lumbar spine MRI TMJ MRI cervical spine MRI thoracic spine MRI lumbar spine MRI sacrum or MRI sacroiliac joints MRI brachial plexus MRI lumbosacral plexus CT neck CTA brain CTA brain/carotids CTA carotids CTA MRA MRA (MR Angiography) brain MRV (MR Venography) brain MRA neck/carotids CTV CTV (CT venography) brain CTV neck

5 BRAIN (see also special brain protocols, next page) MRI Brain without contrast CPT MRI brain without and with contrast CPT Acute stroke/tia Chiari malformation Dementia/memory loss (see special protocols) Dizziness Headache Hemorrhage for acute hemorrhage, can also consider CT brain without contrast Neurologic deficit Normal pressure hydrocephalus/aqueductal stenosis Trauma for acute trauma, can also consider CT brain without contrast Vision changes (if suspect a central pathology; see special protocols) Infection Meningitis Cranial neuropathy (please specify which nerves in history and see special protocols) History of cancer with suspected metastases Inflammatory conditions (e.g. history of sarcoidosis, lupus, vasculitis) CT brain without contrast CPT CT brain with contrast CPT Acute head trauma Any head/brain pathology for which MRI is contraindicated Infection/history of cancer with suspected metastases/inflammatory conditions Any head/brain pathology for which MRI is contraindicated

6 BRAIN - Special protocols for MRI Memory loss protocol - MRI brain (without contrast) CPT Dementia Memory loss Orbit protocol - MRI brain without and with contrast CPT Cranial nerve deficits (CN 2, 3, 4, 5, 6) Diplopia Orbit or periorbital mass Optic neuropathy or optic neuritis Visual changes (if suspect orbital pathology) Grave s disease (thyroid orbitopathy) Internal Auditory Canal protocol - MRI brain without and with contrast CPT Pituitary/Sella protocol - MRI brain without and with contrast CPT Tinnitus (pulsatile and nonpulsatile) Bell s palsy Hearing loss (suspected vest. schwannoma) -If suspect temporal bone pathology, CT temporal bone without contrast Tinnitus (pulsatile and nonpulsatile) Cerebellopontine angle mass Hyperprolactinemia Hypogonadism Pituitary adenoma Skull base protocol - MRI brain without and with contrast CPT Skull base mass or pathology Multiple sclerosis protocol - MRI brain without and with contrast CPT Multiple sclerosis Paranasal sinus protocol - MRI brain without and with contrast CPT Sinus tumor/mass/infection (begin with CT sinus without contrast) Cranial nerve 1 (olfactory) pathology Seizure/Epilepsy protocol - MRI brain without and with contrast CPT Seizures or epilepsy Trigeminal Neuralgia protocol - MRI brain without and with contrast CPT Atypical facial pain Trigeminal neuralgia

7 BRAIN - Special protocols for CT CT sinus without contrast (preferred over MRI) CPT CT orbit without contrast CPT CT orbit with contrast CPT CT facial bones without contrast (Includes all facial bones inc. mandible) CT facial bones with contrast (includes all facial bones inc. mandible) CPT CT TMJ without contrast CPT CT pituitary with contrast CPT CT temporal bone without contrast CPT Sinus disease; if sinus tumor/mass/aggressive infection prefer MRI Trauma, foreign body, thyroid orbitopathy, or when MRI contraindicated Orbital infection, or when MRI contraindicated Trauma Facial infection/tumor when MR contraindicated TMJ pathology to assess for bony changes If MRI contraindicated; see MRI pituitary Conductive hearing loss; cholesteatoma; inner ear prosthesis; MRI contraindication

8 NECK MRI neck without and with contrast CPT CT neck with contrast only CPT CT neck without contrast CPT Infection Mass/lump Salivary gland pathology Cancer follow up/history of cancer with suspected metastases Inflammatory conditions (e.g. history of sarcoidosis, lupus, vasculitis) Adenopathy Dysphagia/odynophagia Vocal cord paralysis Infection Mass/lump Salivary gland pathology Cancer follow up/history of cancer with suspected metastases Inflammatory conditions (e.g. history of sarcoidosis, lupus, vasculitis) Adenopathy Dysphagia/odynophagia Vocal cord paralysis Salivary gland stone or allergic to CT dye or renal dysfunction (see criteria) TMJ MRI TMJ without contrast CPT TMJ disorders MRI TMJ without and with contrast CPT TMJ disorder History of inflammatory arthropathy (e.g. rheumatoid arthritis)

9 SPINE (specify cervical, thoracic, or lumbar) MRI (C/T/L) spine without contrast Cervical CPT Thoracic CPT Lumbar CPT MRI (C/T/L) Spine without and with contrast Cervical CPT Thoracic CPT Lumbar CPT CT (C/T/L) Spine without contrast Cervical CPT Thoracic CPT Lumbar CPT MRI Lumbosacral plexus without contrast CPT MRI Lumbosacral plexus without and with contrast Neck/back pain or radiculopathy Spinal stenosis Cord compression Degenerative disease Paresthesias Sciatica Compression fracture Trauma (if MRI contraindicated, consider CT without contrast) Syrinx (follow-up) initial workup should be with contrast Spondylolisthesis/stress fracture, CT better for spondylolysis Vertebroplasty planning Multiple sclerosis Myelopathy History of prior spine surgery (thoracic or lumbar) Epidural abscess Discitis/osteomyelitis Spinal cord tumor (diagnosis and/or follow up) Infection/inflammatory processes (e.g. sarcoidosis) Syrinx (initial evaluation) Similar indications to MRI, but use if MRI contraindicated Assess bony lesions/bony anatomy/bony degenerative changes Assess post operative hardware/fusion Lumbar plexus pathology Lumbar plexus (suspected mass, infection, neuritis, hx cancer) MRI Brachial plexus without contrast CPT MRI Brachial plexus without and with contrast Brachial plexus pathology Brachial plexus (suspected mass, infection, neuritis, hx cancer)

10 VASCULAR (ANGIOGRAPHY/VENOGRAPHY) MRA of the brain without contrast CPT Aneurysm suspected or screening Follow up of untreated aneurysm Assess intracranial vasculature (CVA/TIA) MRA of the brain without and with contrast CPT Follow up of TREATED aneurysm (clipped or coiled) Suspicion for arteriovenous malformation Suspicion for dural arteriovenous fistula MRA of the neck without and with contrast CPT MRA of the neck without contrast CPT MRV of the brain without and with contrast CPT CTA of the brain with contrast CPT CTA of the brain and neck with contrast CPT 70496, CTA of the neck with contrast CPT CTV of the brain with contrast CPT Stenosis carotid or vertebral Dissection carotid or vertebral Abnormal Carotid Doppler (prefer CTA head/neck) Subclavian steal (prefer CTA head/neck) If contrast is contraindicated Dural venous sinus thrombosis Aneurysm (if MRA contraindicated); aneurysm follow up Intracranial stenoses/occlusion AVM, or arteriovenous fistula Assess vascular stenosis or occlusion Dissection Assess vascular stenosis or occlusion Dissection Dural venous sinus thrombosis

ORDERING GUIDELINES: MRI

ORDERING GUIDELINES: MRI ORDERING GUIDELINES: MRI GENERAL INFORMATION: Pregnant Patients May undergo an MRI exam at any stage of pregnancy if the risk-benefit ratio to the patient warrants the study be performed. Present data

More information

Neuroradiology MR Protocols

Neuroradiology MR Protocols Neuroradiology MR Protocols Brain protocols N 1: Brain MRI without contrast N 2: Pre- and post-contrast brain MRI N 3 is deleted N 4: Brain MRI without or pre-/post-contrast (seizure protocol) N 5: Pre-

More information

Physicians at-a-glance

Physicians at-a-glance Mayfield Office Locations Physicians at-a-glance Middletown Ohio Physicians Hamilton 129 Fairfield West 2 Forest Park Areas of expertise pituitary tumors, brain tumors, aneurysms, arteriovenous malformations,

More information

Clinical Policy: Evoked Potential Testing Reference Number: CP.MP.134

Clinical Policy: Evoked Potential Testing Reference Number: CP.MP.134 Clinical Policy: Evoked Potential Testing Reference Number: CP.MP.134 Effective Date: 01/17 Last Review Date: 11/17 Coding Implications Revision Log See Important Reminder at the end of this policy for

More information

Magnetic Resonance Imaging. Basics of MRI in practice. Generation of MR signal. Generation of MR signal. Spin echo imaging. Generation of MR signal

Magnetic Resonance Imaging. Basics of MRI in practice. Generation of MR signal. Generation of MR signal. Spin echo imaging. Generation of MR signal Magnetic Resonance Imaging Protons aligned with B0 magnetic filed Longitudinal magnetization - T1 relaxation Transverse magnetization - T2 relaxation Signal measured in the transverse plane Basics of MRI

More information

Spontaneous Intracranial Hypotension Diagnosis and Treatment

Spontaneous Intracranial Hypotension Diagnosis and Treatment Spontaneous Intracranial Hypotension Diagnosis and Treatment John W. Engstrom MD, Philip R. Weinstein MD, and William P. Dillon M.D. University of California, San Francisco Spontaneous Intracranial Hypotension

More information

Overview of imaging modalities for cerebral aneurysms

Overview of imaging modalities for cerebral aneurysms Overview of imaging modalities for cerebral aneurysms Soroush Zaghi BIDMC PCE: Radiology August 2008 (Images from BIDMC, PACS.) Our Patient: Presentation Our patient is a 57 y/o woman who reports blowing

More information

PEDIATRIC and CONGENITAL HEAD IMAGING GUIDELINES

PEDIATRIC and CONGENITAL HEAD IMAGING GUIDELINES MedSolutions, Inc. Clinical Decision Support Tool Diagnostic Strategies This tool addresses common symptoms and symptom complexes. Imaging requests for patients with atypical symptoms or clinical presentations

More information

screening; including image post processing CT, heart; without contrast material; with Requires authorization

screening; including image post processing CT, heart; without contrast material; with Requires authorization 0042T Cerebral perfusion analysis using CT; with ; including of parametric maps with determination of cerebral blood flow, cerebral blood volume, and mean transit time 74263 Computed tomographic (CT) colonography,

More information

Block 3 VIRGINIA CAMPUS Neurological System and Special Senses 2017

Block 3 VIRGINIA CAMPUS Neurological System and Special Senses 2017 WEEK 1 Time/Date Monday, January 30 Tuesday, January 31 Wednesday, February 1 Thursday, February 2 Friday, February 3 1. PATHOLOGY 2-3. NEUROSCIENCE 6. NEUROSCIENCE 9-10. NEUROSCIENCE 11. NEUROSCIENCE

More information

CT PROCEDURE REFERENCE GUIDE 2017

CT PROCEDURE REFERENCE GUIDE 2017 Head CT PROCEDURE REFERENCE GUIDE 2017 Procedure Contrast Scan Field Preparatio n Base of Skull to Vertex Sinuses Orbits Mastoids/IAC/ Temporal Bones Facial Bones ST Neck Low Dose Lung Screening Routine

More information

PA SYLLABUS. Syllabus for students of the FACULTY OF MEDICINE No.2

PA SYLLABUS. Syllabus for students of the FACULTY OF MEDICINE No.2 Approved At the meeting of the Faculty Council Medicine No. of Approved At the meeting of the chair of Neurosurgery No. of Dean of the Faculty Medicine No.2 PhD, associate professor M. Betiu Head of the

More information

MedStar Health, Inc. POLICY AND PROCEDURE MANUAL

MedStar Health, Inc. POLICY AND PROCEDURE MANUAL MedStar Health, Inc. POLICY AND PROCEDURE MANUAL MP.049.MH Visually Evoked Response Test This policy applies to the following lines of business: MedStar Employee (Select) MedStar MA DSNP CSNP MedStar CareFirst

More information

AIM 2014 CPT Radiology & Cardiac Codes Requiring Review

AIM 2014 CPT Radiology & Cardiac Codes Requiring Review AIM 2014 CPT Radiology & Cardiac Codes Requiring Review Modality Body Part CT Head 1 70480 CT orbit, sella or posterior fossa; w/o contrast 1 CT Head 1 70481 CT orbit, sella or posterior fossa; with CT

More information

Meningioma tumor. Meningiomas are named according to their location (Fig. 1) and cause various symptoms: > 1

Meningioma tumor. Meningiomas are named according to their location (Fig. 1) and cause various symptoms: > 1 Meningioma tumor Overview A meningioma is a type of tumor that grows from the protective membranes, called meninges, which surround the brain and spinal cord. Most meningiomas are benign (not cancer) and

More information

2012 CPT Radiology Codes Requiring Review Blue Cross and Blue Shield of Louisiana

2012 CPT Radiology Codes Requiring Review Blue Cross and Blue Shield of Louisiana 2012 CPT Radiology Codes Requiring Review Blue Cross and Blue Shield of Louisiana CT Head 70480 CT orbit, sella or posterior fossa; w/o CT Head 70481 CT orbit, sella or posterior fossa; with CT Head 70482

More information

List of Clinical Indicators for MRI Scans

List of Clinical Indicators for MRI Scans MRI s List of Clinical Indicators for MRI Scans The following list of s is for guidance purposes only and is effective 1 st March 2017. We recommend that if members are referred for an MRI scan and they

More information

Medical Policy An independent licensee of the Blue Cross Blue Shield Association

Medical Policy An independent licensee of the Blue Cross Blue Shield Association CTA and MRA of Head, Neck, Abdomen, Pelvis, Lower Extremities Page 1 of 11 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Computed Tomographic Angiography (CTA)

More information

Neurology Goals: Knowledge:

Neurology Goals: Knowledge: Neurology Goals: A solid understanding of normal neurological development, anatomy and neurophysiology is imperative to the treatment of neurological pathology. The goal is to sensitize the family medicine

More information

Chapter 3 Diagnostic Imaging. 1 Diagnostic Imaging

Chapter 3 Diagnostic Imaging. 1 Diagnostic Imaging Chapter 3 Diagnostic Imaging 1 Diagnostic Imaging Radiographic Examination: Standards and Indications Position Statement Radiography should only be performed on the basis of clinical necessity as judged

More information

Louisiana State University Health Sciences Center

Louisiana State University Health Sciences Center Louisiana State University Health Sciences Center Department of Neurosurgery Student Clerkship Guide 2017 2018 Introduction Welcome to LSUHSC New Orleans neurosurgery rotation. Our department is dedicated

More information

73725x2 MRA Pelvis Runoff (to ankle) CTA Abdomen with & without CTA Cardiac Brain without 70551

73725x2 MRA Pelvis Runoff (to ankle) CTA Abdomen with & without CTA Cardiac Brain without 70551 CT CT Myelogram MRI Abdomen without 74150 Cervical 62302 Abdomen / MRCP 74181 Abdomen with 74160 Thoracic 62303 Abdomen / MRCP with & without 74183 Abdomen with & without 74170 Lumbar 62304 Abdomen / Pelvis

More information

Cranial Nerves and Spinal Cord Flashcards

Cranial Nerves and Spinal Cord Flashcards 1. Name the cranial nerves and their Roman numeral. 2. What is Cranial Nerve I called, and what does it 3. Scientists who are trying to find a way to make neurons divide to heal nerve injuries often study

More information

Pediatric Imaging Spine MRI and Spine CT Test Request Tip Sheet

Pediatric Imaging Spine MRI and Spine CT Test Request Tip Sheet Pediatric Imaging Spine MRI and Spine CT MRI is almost always preferred over CT scan; if ordering CT, CLEARLY document why MRI is not appropriate. In cases of ongoing back pain, six weeks of conservative

More information

ANATOMY & PHYSIOLOGY I Laboratory Version B Name Section. REVIEW SHEET Exercise 10 Axial Skeleton

ANATOMY & PHYSIOLOGY I Laboratory Version B Name Section. REVIEW SHEET Exercise 10 Axial Skeleton ANATOMY & PHYSIOLOGY I Laboratory Version B Name Section REVIEW SHEET Exercise 10 Axial Skeleton 1 POINT EACH. THE SKULL MULTIPLE CHOICE 1. The major components of the axial skeleton include the 7. The

More information

Identifying Cerebrovascular Disorders. Wengui Yu, MD, PhD Department of Neurology, University of California, Irvine

Identifying Cerebrovascular Disorders. Wengui Yu, MD, PhD Department of Neurology, University of California, Irvine Identifying Cerebrovascular Disorders Wengui Yu, MD, PhD Department of Neurology, University of California, Irvine Objectives Review different types of cerebrovascular disorders. Briefly discuss etiology,

More information

American British Course in Neuroradiology -ABCNRMumbai, India 6th-8th October, 2017

American British Course in Neuroradiology -ABCNRMumbai, India 6th-8th October, 2017 A B C N R American British Course in Neuroradiology -ABCNRMumbai, India 6th-8th October, 2017 Register at: Course Objectives: To provide comprehensive teaching in all aspects of Adult and Paediatric Brain

More information

AMERICAN IMAGING MANAGEMENT

AMERICAN IMAGING MANAGEMENT 2012 CPT Codes Computerized Tomography (CT) CPT Description Abdomen 74150 CT abdomen; w/o 74160 CT abdomen; with 74170 CT abdomen; w/o followed by Chest 71250 CT thorax; w/o 71260 CT thorax; with 71270

More information

Basics of Interventional Radiology Coding 2017

Basics of Interventional Radiology Coding 2017 Basics of Interventional Radiology Coding 2017 Prepared and Published By: MedLearn Publishing A Division of Panacea Healthcare Solutions, Inc. 287 East Sixth Street, Suite 400 St. Paul, MN 55101 1-800-252-1578

More information

Workbook Answers Chapter 13. Neurologic Diseases and Conditions

Workbook Answers Chapter 13. Neurologic Diseases and Conditions Workbook Answers Chapter 13 Neurologic Diseases and Conditions Short Answer 1. Afferent nerves transmit impulses from parts of the body to the spinal cord; efferent nerves transmit impulses away from the

More information

5. Headache. and/or neck trauma. attributed to moderate. head injury. Glasgow Coma Scale x/15. ICHD II- Chaps 5&6 Posttraumatic and Vascular Headaches

5. Headache. and/or neck trauma. attributed to moderate. head injury. Glasgow Coma Scale x/15. ICHD II- Chaps 5&6 Posttraumatic and Vascular Headaches Diagnosis and Classification of Secondary Headaches Part 1 Posttraumatic and Vascular Morris Levin, MD Associate Professor of Medicine (Neurology) Associate Professor of Psychiatry Dartmouth Medical School

More information

Introduction to Neuroimaging Aaron S. Field, MD, PhD Assistant Professor of Radiology Neuroradiology Section University of Wisconsin Madison

Introduction to Neuroimaging Aaron S. Field, MD, PhD Assistant Professor of Radiology Neuroradiology Section University of Wisconsin Madison Introduction to Neuroimaging Aaron S. Field, MD, PhD Assistant Professor of Radiology Neuroradiology Section University of Wisconsin Madison Updated 7/17/07 Neuroimaging Modalities Radiography (X-Ray)

More information

Spinal Vascular Lesions

Spinal Vascular Lesions Spinal Vascular Lesions Spinal Vascular Lesions Spinal cord infarction Hemangioblastoma Cavernous malformation Vascular malformations (Type 1-4) Spinal artery aneurysm Troy Hutchins, MD Assistant Professor

More information

Nervous System. Student Learning Objectives:

Nervous System. Student Learning Objectives: Nervous System Student Learning Objectives: Identify the primary parts of the neuron Identify the major structures of the central nervous system Identify the major structures of the peripheral nervous

More information

2010 Radiology Prior Authorization List for UnitedHealthcare s HealthChoice Members

2010 Radiology Prior Authorization List for UnitedHealthcare s HealthChoice Members 70336 MR TEMPOROMANDIBULAR JOINT 70450 CT, HEAD OR BRAIN; WITHOUT MATERIAL 70460 CT HEAD/BRAIN W/ 70470 CT HEAD/BRAIN W/O & W/ 70480 CT, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MID 70481 CT ORBIT W/

More information

North Oaks Trauma Symposium Friday, November 3, 2017

North Oaks Trauma Symposium Friday, November 3, 2017 Traumatic Intracranial Hemorrhage Aaron C. Sigler, DO, MS Neurosurgery Tulane Neurosciences None Disclosures Overview Anatomy Epidural hematoma Subdural hematoma Cerebral contusions Outline Traumatic ICH

More information

Daniel A Capen MD Downey Orthopedic Group COMPLICATIONS IN CERVICAL AND LUMBAR SPINAL SURGERY

Daniel A Capen MD Downey Orthopedic Group COMPLICATIONS IN CERVICAL AND LUMBAR SPINAL SURGERY Daniel A Capen MD Downey Orthopedic Group COMPLICATIONS IN CERVICAL AND LUMBAR SPINAL SURGERY Complications in Spinal Surgery Positioning Complications Approach Complications Procedure Complications Post-surgical

More information

Guide to Draw It to Know It Neuroanatomy (relative to Medical Neuro, UI-COM Urbana)

Guide to Draw It to Know It Neuroanatomy (relative to Medical Neuro, UI-COM Urbana) Guide to Draw It to Know It Neuroanatomy (relative to Medical Neuro, UI-COM Urbana) Note: Sometimes DITKI goes into far more detail than is necessary for the course, and in other cases not enough. As helpful

More information

Clinical indications for positron emission tomography

Clinical indications for positron emission tomography Clinical indications for positron emission tomography Oncology applications Brain and spinal cord Parotid Suspected tumour recurrence when anatomical imaging is difficult or equivocal and management will

More information

2016 CPT Code Reference Guide. T F imaginghealthcare.com

2016 CPT Code Reference Guide. T F imaginghealthcare.com 2016 CPT Code Reference Guide T 866 558 4320 F 866 558 4329 imaginghealthcare.com HEAD/NECK & NEURO MRI brain - post fossa w/ & w/o contrast (IAC w/ & w/o) MRI brain (pituitary protocol) w/ & w/o contrast

More information

Intake Questionnaire ADVANCED IMAGING

Intake Questionnaire ADVANCED IMAGING Please answer all questions below and notify the technologist of any metal inside or on your body. For MRI s, please remove all removable metal from your body such as hearing aides, hairpins, jewelry,

More information

10/19/12. Uncommon Causes of Stroke. José Biller, MD, FACP, FAAN, FAHA Disclosures. Dr. Biller has no disclosures to report

10/19/12. Uncommon Causes of Stroke. José Biller, MD, FACP, FAAN, FAHA Disclosures. Dr. Biller has no disclosures to report 10/19/12 Uncommon Causes of Stroke José Biller, MD, FACP, FAAN, FAHA Loyola University Chicago Stritch School of Medicine Chicago, IL José Biller, MD, FACP, FAAN, FAHA Disclosures Dr. Biller has no disclosures

More information

An Introduction to Imaging the Brain. Dr Amy Davis

An Introduction to Imaging the Brain. Dr Amy Davis An Introduction to Imaging the Brain Dr Amy Davis Common reasons for imaging: Clinical scenarios: - Trauma (NICE guidelines) - Stroke - Tumours - Seizure - Neurological degeneration memory, motor dysfunction,

More information

Clinical Appropriateness Guidelines: Advanced Imaging

Clinical Appropriateness Guidelines: Advanced Imaging Clinical Appropriateness Guidelines: Advanced Imaging Appropriate Use Criteria: Imaging of the Spine Effective Date: September 5, 2017 Proprietary Date of Origin: 03/30/2005 Last revised: 07/26/2016 Last

More information

OP-8: MRI LUMBAR SPINE FOR LOW BACK PAIN

OP-8: MRI LUMBAR SPINE FOR LOW BACK PAIN Description of Measure OP-8: MRI LUMBAR SPINE FOR LOW BACK PAIN This measure calculates the percentage of MRI of the Lumbar Spine studies with a diagnosis of low back pain on the imaging claim and for

More information

2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Efficiency

2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Efficiency Quality ID #419: Overuse Of Neuroimaging For Patients With Primary Headache And A Normal Neurological Examination National Quality Strategy Domain: Efficiency and Cost Reduction 2018 OPTIONS FOR INDIVIDUAL

More information

Aberrant sylvian vein: A newly described cause of pulsatile tinnitus

Aberrant sylvian vein: A newly described cause of pulsatile tinnitus Special Issue: Systemic disease and otolaryngology-related disease Aberrant sylvian vein: A newly described cause of pulsatile tinnitus Journal of International Medical Research 2017, Vol. 45(5) 1481 1485!

More information

Painting pictures of the brain with numbers

Painting pictures of the brain with numbers Painting pictures of the brain with numbers Neurology for Insurers Dr Ian Cox & Adele Groyer Gen Re Overview Critical Illness Product Background Why should we be interested in neurology? Consult our doctor

More information

RADPrimer Curriculum Breast Topics Covered Basic Intermediate 225

RADPrimer Curriculum Breast Topics Covered Basic Intermediate 225 Breast Anatomy & Normal Variants 11 Breast Imaging Modalities 13 BI RADS Lexicon 3 Mammography: Masses 9 Mammography: Calcifications 17 Mammography: Additional Findings 8 Ultrasound Features 10 Ultrasound

More information

Interventional Pain Management

Interventional Pain Management Origination: 5/21/08 Revised: 10/02/17 Annual Review: 11/02/17 Purpose: To provide interventional pain management clinical coordination criteria for the Medical Department staff to reference when making

More information

Evaluation of Neck Mass. Disclosure. Learning Objectives 3/24/2014. Karen T. Pitman MD, FACS Banner MDACC, Gilbert AZ. Nothing to disclose

Evaluation of Neck Mass. Disclosure. Learning Objectives 3/24/2014. Karen T. Pitman MD, FACS Banner MDACC, Gilbert AZ. Nothing to disclose Evaluation of Neck Mass Karen T. Pitman MD, FACS Banner MDACC, Gilbert AZ Nothing to disclose Disclosure Learning Objectives 1. Describe a systematic method to evaluate a patient with a neck mass 2. Select

More information

American College of Radiology ACR Appropriateness Criteria Orbits, Vision and Visual Loss

American College of Radiology ACR Appropriateness Criteria Orbits, Vision and Visual Loss Revised 2017 American College of Radiology ACR Appropriateness Criteria Orbits, Vision and Visual Loss Variant 1: Traumatic visual defect. Suspect orbital injury. Initial imaging. Procedure Appropriateness

More information

HBA THE BODY Head & Neck Written Examination October 23, 2014

HBA THE BODY Head & Neck Written Examination October 23, 2014 HBA 531 - THE BODY Head & Neck Written Examination October 23, 2014 Name: NOTE 2: When asked to trace nerve, artery, or vein pathways, do so by using arrows, e.g., structure a structure b structure c...

More information

Arterial Map of the Thorax, Abdomen and Pelvis 2017 Edition

Arterial Map of the Thorax, Abdomen and Pelvis 2017 Edition Arterial Map of the Thorax, Abdomen and Pelvis Angiography 75605 (-26) Aortography, thoracic 75625 (-26) Aortography, abdominal by serialography 75630 (-26) Aortography, abdominal + bilat iliofemoral 75705

More information

EPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN

EPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN EPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN UnitedHealthcare Oxford Clinical Policy Policy Number: PAIN 019.21 T2 Effective Date: October 1, 2017 Table of Contents Page INSTRUCTIONS FOR USE...

More information

Outline. Neuroradiology. Diffusion Imaging in. Clinical Applications of. Basics of Diffusion Imaging. Basics of Diffusion Imaging

Outline. Neuroradiology. Diffusion Imaging in. Clinical Applications of. Basics of Diffusion Imaging. Basics of Diffusion Imaging Clinical Applications of Diffusion Imaging in Neuroradiology No disclosures Stephen F. Kralik Assistant Professor of Radiology Indiana University School of Medicine Department of Radiology and Imaging

More information

Neuro-MRI Exam Ordering Guide

Neuro-MRI Exam Ordering Guide Neuro-MRI Exam Ordering Guide Dear Colleague, This list is meant to assist you when placing an order for a Neuro-MRI examination. The list includes common indications for neuro-mri as well as recommendations

More information

AMERICAN ACADEMY OF NEUROLOGY SPINE FELLOWSHIP CORE CURRICULUM

AMERICAN ACADEMY OF NEUROLOGY SPINE FELLOWSHIP CORE CURRICULUM AMERICAN ACADEMY OF NEUROLOGY SPINE FELLOWSHIP CORE CURRICULUM Introduction Spine conditions affect virtually everyone at some time during their life. Surveys indicate a yearly prevalence of spine-related

More information

Cavernous sinus thrombosis: Departmental guidelines

Cavernous sinus thrombosis: Departmental guidelines Michele Long Division of Otorhinolaryngology Faculty of Health Sciences Tygerberg Campus, University of Stellenbosch Cavernous sinus thrombosis: Departmental guidelines Anatomy- cavernous sinus 2cm in

More information

2014 CPT Radiology Codes Requiring Review

2014 CPT Radiology Codes Requiring Review CT Head 1 70480 CT orbit, sella or posterior fossa; w/o contrast 1 CT Head 1 70481 CT orbit, sella or posterior fossa; with CT orbit, sella or posterior fossa; w/o contrast CT Head 1 70482 followed by

More information

Michael Horowitz, MD Pittsburgh, PA

Michael Horowitz, MD Pittsburgh, PA Michael Horowitz, MD Pittsburgh, PA Introduction Cervical Artery Dissection occurs by a rupture within the arterial wall leading to an intra-mural Hematoma. A possible consequence is an acute occlusion

More information

Post Operative Care Following Spinal Surgery For A Cervical Herniated Disc

Post Operative Care Following Spinal Surgery For A Cervical Herniated Disc Post Operative Care Following Spinal Surgery For A Cervical Herniated Disc The patient services department (PSD) supports LSI patients post surgery. Herniated Disc searching for the most effective solution

More information

Unit #3: Dry Lab A. David A. Morton, Ph.D.

Unit #3: Dry Lab A. David A. Morton, Ph.D. Unit #3: Dry Lab A David A. Morton, Ph.D. Skull Intracranial Hemorrhage Pg. 26 Epidural Hematoma Pg. 26 Skull Pg. 26 Subdural Hematoma Pg. 26 Subdural Hematoma Pg. 26 Subarachnoid Hemorrhage Pg. 26 Subarachnoid

More information

Ne u r o r a d i o l o g y

Ne u r o r a d i o l o g y A DVD Teaching Program 2010 Ne u r o r a d i o l o g y in Clinical Practice Superior Image Quality FREE SYLLABUS with purchase of entire set 18 AMA PRA Category 1 Credits tm Educational Symposia Release

More information

Chiari Malformation: Diagnosis

Chiari Malformation: Diagnosis Chiari Malformation: Diagnosis SYMPTOMS DIAGNOSIS LIVING WITH CHIARI TREATMENT Rick Labuda, Executive Director director@conquerchiari.org 724-940-0116 Disclaimer: This presentation is intended for informational

More information

American College of Radiology ACR Appropriateness Criteria Headache Child

American College of Radiology ACR Appropriateness Criteria Headache Child Revised 2017 American College of Radiology ACR Appropriateness Criteria Headache Child Variant 1: Child. Primary headache. Initial imaging. Procedure Appropriateness Category Relative Radiation Level Arteriography

More information

The Upledger Institute

The Upledger Institute The Upledger Institute 11211 Prosperity Farms Rd D325 Palm Beach Gardens, FL 33410-3487 800 233-5880 l 561 622-4334 l 561 622-4771 (fax) The Upledger Institute International is a proud member of the International

More information

M555 Medical Neuroscience Blood Flow in CNS Meninges Blood Brain Barrier CSF

M555 Medical Neuroscience Blood Flow in CNS Meninges Blood Brain Barrier CSF M555 Medical Neuroscience Blood Flow in CNS Meninges Blood Brain Barrier CSF Arterial Blood Flow to CNS approximately % of what goes wrong within the skull that produces neurological deficits is vascular

More information

Presentation & Management of Raised Intracranial Pressure. Professor of Neurosurgery

Presentation & Management of Raised Intracranial Pressure. Professor of Neurosurgery Presentation & Management of Raised Intracranial Pressure By Zain Alabedeen B. Jamjoom,, M.D. Professor of Neurosurgery Normal Intracranial Pressure Normal ICP ~10 mmhg (supine at the level of the foramen

More information

Neck CTA: When? How? The Innsbruck Experience Marius C. Wick, M.D. Department of Radiology Karolinska University Hospital Solna Stockholm, Sweden

Neck CTA: When? How? The Innsbruck Experience Marius C. Wick, M.D. Department of Radiology Karolinska University Hospital Solna Stockholm, Sweden Neck CTA: When? How? The Innsbruck Experience Marius C. Wick, M.D. Department of Radiology Karolinska University Hospital Solna Stockholm, Sweden No financial or non-financial competing interests to declare

More information

Interventional treatment of Vascular Abnormalities

Interventional treatment of Vascular Abnormalities Interventional treatment of Vascular Abnormalities Edison P. Valle, M.D. Ochsner Neurosurgery. Comprehensive treatment of Neurovascular Abnormalities Disclosures Tools for treatment Open neuro-vascular

More information

3-Deep fascia: is absent (except over the parotid gland & buccopharngeal fascia covering the buccinator muscle)

3-Deep fascia: is absent (except over the parotid gland & buccopharngeal fascia covering the buccinator muscle) The Face 1-Skin of the Face The skin of the face is: Elastic Vascular (bleed profusely however heal rapidly) Rich in sweat and sebaceous glands (can cause acne in adults) It is connected to the underlying

More information

MP.098.MH Trigger Point and Transforaminal Epidural Injections

MP.098.MH Trigger Point and Transforaminal Epidural Injections MedStar Health, Inc. POLICY AND PROCEDURE MANUAL MP.098.MH Trigger Point and Transforaminal Epidural Injections This policy applies to the following lines of business: MedStar Employee (Select) MedStar

More information

Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Jurisdiction Texas. Retirement Date N/A

Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Jurisdiction Texas. Retirement Date N/A Local Coverage Determination (LCD): Chiropractic Services (L35424) Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Contractor Information Contractor

More information

A/Prof Mel Cusi.

A/Prof Mel Cusi. www.orthosports.com.au 47-49 Burwood Road, Concord 29-31 Dora Street, Hurstville 119-121 Lethbridge Street, Penrith 160 Belmore Road, Randwick My approach to a patient with low back pain MBBS, FACSEP,

More information

L M Thornton, MD; L Lanier, MD; C L Sistrom, MD; D Rajderkar, MD; A Mancuso, MD; IM Schmalfuss, MD University of Florida, Gainesville Department of

L M Thornton, MD; L Lanier, MD; C L Sistrom, MD; D Rajderkar, MD; A Mancuso, MD; IM Schmalfuss, MD University of Florida, Gainesville Department of L M Thornton, MD; L Lanier, MD; C L Sistrom, MD; D Rajderkar, MD; A Mancuso, MD; IM Schmalfuss, MD University of Florida, Gainesville Department of Radiology RSNA Annual Meeting 2016 Trainee call readiness

More information

The Temporal Bone Anatomy & Pathology

The Temporal Bone Anatomy & Pathology Department of Radiology University of California San Diego The Temporal Bone Anatomy & Pathology John R. Hesselink, M.D. Temporal Bone Axial View Temporal Bone Coronal View Longitudinal Fracture The Temporal

More information

ICD10 CODES CODE DESCRIPTION R Abnormal auditory function study H Abnormal auditory perception, bilateral H Abnormal auditory

ICD10 CODES CODE DESCRIPTION R Abnormal auditory function study H Abnormal auditory perception, bilateral H Abnormal auditory ICD10 CODES CODE DESCRIPTION R94.120 Abnormal auditory function study H93.293 Abnormal auditory perception, bilateral H93.292 Abnormal auditory perception, left ear H93.291 Abnormal auditory perception,

More information

Sinus and Cerebral Vein Thrombosis

Sinus and Cerebral Vein Thrombosis Sinus and Cerebral Vein Thrombosis A Summary Sinus and cerebral vein clots are uncommon. They can lead to severe headaches, confusion, and stroke-like symptoms. They may lead to bleeding into the surrounding

More information

Post-op Carotid Complications A Nursing Perspective of What to Watch Out for

Post-op Carotid Complications A Nursing Perspective of What to Watch Out for Post-op Carotid Complications A Nursing Perspective of What to Watch Out for By Kariss Peterson, ARNP Swedish Medical Center Inpatient Neurology Team 1 Post-op Carotid Management Objectives Review the

More information

P1: OTA/XYZ P2: ABC c01 BLBK231-Ginsberg December 23, :43 Printer Name: Yet to Come. Part 1. The Neurological Approach COPYRIGHTED MATERIAL

P1: OTA/XYZ P2: ABC c01 BLBK231-Ginsberg December 23, :43 Printer Name: Yet to Come. Part 1. The Neurological Approach COPYRIGHTED MATERIAL Part 1 The Neurological Approach COPYRIGHTED MATERIAL 1 2 Chapter 1 Neurological history-taking The diagnosis and management of diseases of the nervous system have been revolutionized in recent years by

More information

Imaging pituitary gland tumors

Imaging pituitary gland tumors November 2005 Imaging pituitary gland tumors Neel Varshney,, Harvard Medical School Year IV Two categories of presenting signs of a pituitary mass Functional tumors present with symptoms due to excess

More information

PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES

PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES CENTRAL NERVOUS SYSTEM EPENDYMOMA Last Revision Date July 2015 1 CNS Site Group Ependymoma Author: Dr. Norm Laperriere 1. INTRODUCTION 3 2.

More information

TRANSVERSE SECTION PLANE Scalp 2. Cranium. 13. Superior sagittal sinus

TRANSVERSE SECTION PLANE Scalp 2. Cranium. 13. Superior sagittal sinus TRANSVERSE SECTION PLANE 1 1. Scalp 2. Cranium 3. Superior sagittal sinus 4. Dura mater 5. Falx cerebri 6. Frontal lobes of the cerebrum 7. Middle meningeal artery 8. Cortex, grey matter 9. Cerebral vessels

More information

LEVEL I CORE PRIVILEGES

LEVEL I CORE PRIVILEGES Delineation of Privileges Department of Neurosurgery Name: Please print or type LEVEL I CORE PRIVILEGES Minimum Training and Experience M.D. or D.O. required. Training in Neurological Surgery including

More information

Head-and-Neck Radiology

Head-and-Neck Radiology Head-and-Neck Radiology Péter Magyar MD. Diagnosztikus képalkotó Lecture eljárások anatómiája 4th year 2007. Semmelweis University Department of Diagnostic Radiology and Oncology Guide-line Parts and borders

More information

An Easy Guide to TENS Pain Relief

An Easy Guide to TENS Pain Relief An Easy Guide to TENS Pain Relief 68 ElectroMedical Solutions 1715 E. Bay Dr. Largo, FL 33771 Toll Free 866-243-TENS (8367) Toll Free Fax 866-242-TENS (8367) www.electromedicalsolutions.com A book of indications,

More information

SAMPLE. Radiology Essential links from CPT codes to ICD-10-CM and HCPCS ICD-10. Cross Coder

SAMPLE. Radiology Essential links from CPT codes to ICD-10-CM and HCPCS ICD-10. Cross Coder Cross Coder www.optumcoding.com Radiology Essential links from CPT codes to ICD-10-CM and HCPCS 2017 a ICD-10 A full suite of resources including the latest code set, mapping products, and expert training

More information

Fundamentals of Neurology

Fundamentals of Neurology Fundamentals of Neurology An Illustrated Guide Bearbeitet von Marco Mumenthaler, Heinrich Mattle 1. Auflage 2005. Taschenbuch. 304 S. Paperback ISBN 978 3 13 136451 7 Format (B x L): 19,5 x 27 cm Weitere

More information

Emergency Neurological Life Support Spinal Cord Compression

Emergency Neurological Life Support Spinal Cord Compression Emergency Neurological Life Support Spinal Cord Compression Version: 2.0 Last Updated: 19-Mar-2016 Checklist & Communication Spinal Cord Compression Table of Contents Emergency Neurological Life Support...

More information

FUNDEMENTALS OF ANATOMY. TBD TBD

FUNDEMENTALS OF ANATOMY. TBD TBD Course Details FUNDEMENTALS OF ANATOMY Course Title Fundamentals of Anatomy Course Number BIOL 160 Department Anatomy Credit Hours 4 Grading Type Letter Course Director Sushama Rich M.D. Director s Email

More information

The Peripheral Nervous System

The Peripheral Nervous System The Peripheral Nervous System Dr. Ali Ebneshahidi ebneshahidi Peripheral Nervous System (PNS) Consists of 12 pairs of cranial nerves and 31 pairs of spinal nerves. Serves as a critical link between the

More information

Veins of the Face and the Neck

Veins of the Face and the Neck Veins of the Face and the Neck Facial Vein The facial vein is formed at the medial angle of the eye by the union of the supraorbital and supratrochlear veins. connected through the ophthalmic veins with

More information