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

Transcription

1 0042T Cerebral perfusion analysis using CT; with ; including of parametric maps with determination of cerebral blood flow, cerebral blood volume, and mean transit time Computed tomographic (CT) colonography, screening; including image post processing Computed tomographic (CT) colonography, diagnostic; including image post processing; without material Computed tomographic (CT) colonography, diagnostic; including image post processing; with material(s) including non images, if performed CT, heart; without material; with quantitative evaluation of coronary calcium CT, heart; with material; for evaluation of cardiac structure and morphology (including 3D image post processing, assessment of cardiac function, and evaluation of venous structures, if performed) CT, heart, coronary arteries and bypass grafts (when present); with material; including 3D image post processing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed) CT, heart; with material; for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image post processing, assessment of cardiac LV function, RV structure and function and evaluation of venous structures, if performed) MRI, Temporomandibular Joint(s) CT, head or brain; without CT, head or brain; with CT, head or brain; without followed by material(s) and further CT, orbit, sella, or posterior fossa or outer, middle, or inner ear; without CT, orbit, sella, or posterior fossa or outer, middle, or inner ear; with 1

2 70482 CT, orbit, sella, or posterior fossa or outer, middle, or inner ear; without material(s) followed by material(s) and further CT, maxillofacial area (sinus); without CT, maxillofacial area (sinus); with CT, maxillofacial area (sinus); without material(s) followed by material(s) and further CT, soft-tissue neck; without CT, soft-tissue neck; with CT, soft-tissue neck; without material(s) followed by material(s) and further CTA, head; with, including non images, if performed, & image CTA, neck; with, including non images, if performed, & image MRI, orbit, face and/or neck; without MRI, orbit, face and/or neck; with Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without material(s) followed by material(s) and further sequences MR Angiography (MRA), head; without MR Angiography (MRA), head; with MR Angiography (MRA), head; without material(s) followed by MR Angiography (MRA), neck; without MR Angiography (MRA), neck; with MR Angiography (MRA), neck; without material(s) followed by MRI, brain (including brain stem); without MRI, brain (including brain stem); with MRI, brain (including brain stem); without material(s) followed by MRI, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration 2

3 70555 MRI, brain, functional MRI; requiring physician or psychologist administration of entire neurofunctional testing CT, chest; without CT, chest; with CT, chest; without material followed by material(s) and further CTA, chest (non-coronary); with, including non images, if performed, & image MRI, chest; without MRI, chest; with MRI, chest; without material followed by MR Angiography (MRA), chest (excluding myocardium); with or without material(s) CT, cervical spine; without CT, cervical spine; with CT, cervical spine; without material followed by material(s) and further CT, thoracic spine; without CT, thoracic spine; with CT, thoracic spine; without material followed by material(s) and further CT, lumbar spine; without CT, lumbar spine; with CT, lumbar spine; without material followed by material(s) and further MRI, spinal canal and contents, cervical; without MRI, spinal canal and contents, cervical; with MRI, spinal canal and contents, thoracic; without MRI, spinal canal and contents, thoracic; with MRI, spinal canal and contents, lumbar; without MRI, spinal canal and contents, lumbar; with MRI, spinal canal and contents, cervical; without material followed by 3

4 72157 MRI, spinal canal and contents, thoracic; without material followed by MRI, spinal canal and contents, lumbar; without material followed by MR Angiography (MRA), spinal canal and contents; with or without material(s) CTA, pelvis; with, including non images, if performed, & image CT, pelvis; without CT, pelvis; with CT, pelvis; without material followed by material(s) and further MRI, pelvis; without MRI, pelvis; with MRI, pelvis; without material followed by material(s) and further MR Angiography (MRA), pelvis; with or without CT, upper extremity; without CT, upper extremity; with CT, upper extremity; without material followed by material(s) and further CTA, upper extremity; with, including non images, if performed, & image post processing MRI, upper extremity, other than joint; without MRI, upper extremity, other than joint; with MRI, upper extremity, other than joint; without material followed by material(s) and further MRI, any joint of upper extremity; without MRI, any joint of upper extremity; with MRI, any joint of upper extremity; without material followed by material(s) and further MR Angiography (MRA), upper extremity; with or without CT, lower extremity; without CT, lower extremity; with 4

5 73702 CT, lower extremity; without material followed by material(s) and further CTA, lower extremity; with, including non images, if performed, & image post processing MRI, lower extremity, other than joint; without MRI, lower extremity, other than joint; with MRI, lower extremity, other than joint; without material followed by material(s) and further MRI, any joint of lower extremity; without MRI, any joint of lower extremity; with MRI, any joint of lower extremity; without material followed by material(s) and further MR Angiography (MRA), lower extremity; with or without Magnetic resonance (eg.proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation Magnetic resonance (eg. proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (list separately in addition to code for primary procedure) CT, abdomen; without CT, abdomen; with CT, abdomen; without material followed by material(s) and further CTA, abdomen; with, including non images, if performed, & image post processing CT, abdomen and pelvis; without CT, abdomen and pelvis; without material in one or both body regions, followed by material(s) and further in one or both body regions CT, abdomen and pelvis; with MRI, abdomen; without MRI, abdomen; with MRI, abdomen; without material followed by material(s) and further 5

6 74185 MR Angiography (MRA), abdomen; with or without Cardiac MRI for morphology and function; without material Cardiac MRI for velocity flow mapping (List separately in addition to code for primary procedure) Cardiac MRI for morphology and function; without material; with stress imaging Cardiac MRI for morphology and function; without material followed by material(s) and further Cardiac MRI for morphology and function; without material followed by material(s) and further ; with stress imaging CTA; abdominal aorta and bilateral iliofemoral lower extremity runoff; with, including non images, if performed, and image D Rendering with interpretation and reporting of CT, MRI, ultrasound, or other tomographic modality; not requiring image post processing on an independent workstation D Rendering with interpretation and reporting of CT, MRI, ultrasound, or other tomographic modality; requiring image post processing on an independent workstation CT, limited or localized follow-up study MR Spectroscopy (MRS) Unlisted CT Procedure (diagnostic, interventional) Unlisted MR Procedure (diagnostic, interventional) MRI, breast; without and/or with ; unilateral MRI, breast, without and/or with ; bilateral CT, bone mineral density study, 1 or more sites; axial skeleton MRI, bone marrow blood supply PET, myocardial imaging, metabolic evaluation PET, myocardial imaging, perfusion; single study at rest or stress PET, myocardial imaging, perfusion; multiple studies at rest and/or stress PET, brain; metabolic evaluation PET, brain; perfusion evaluation PET imaging, limited area (e.g., chest, head/neck) 6

7 78812 PET imaging, skull base to mid-thigh PET imaging, whole body PET imaging with concurrently acquired CT for attenuation correction and anatomical localization, limited area (e.g., chest, head/neck) PET imaging with concurrently acquired CT for attenuation correction and anatomical localization, skull base to mid-thigh PET imaging with concurrently acquired CT for attenuation correction and anatomical localization, whole body S8035 Magnetic Source Imaging S8037 MRCP (Magnetic Resonance Cholangiopancreatography) S8042 MRI, low field S8092 CT electron beam (ultrafast CT, cine CT) S8032 Low dose CT lung screening 7