EXAMS_ Page 1/5 SORTED - NUMERIC
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1 BIOPSY 19103L-MR MV MR Guided Breast Biopsy, Vac Assist - LT 19103, 77021, 10022, 19295, 90772, A4550, L-ST MV Stereotactic Breast Biopsy, Vac Assist - LT 19103, 77031, 10022, 19295, 90772, A4550, 99000, L-US MV US Guided Breast Biopsy, Vac Assist - LT 19103, 76942, 10022, 19295, 90772, A4550, 99000, US Guided Face and Neck Biopsy (FNA) 21550, 76536, 76942, 90772, A4550, US Guided Thyroid Biopsy 60100, 60001, 76536, 76942, 90772, A4550, L-MR MV MR Guided Breast Biopsy - LT, Non-Vac Assist ***TRADITIONAL*** 19102, 77021, 10022, 19295, 90772, A4550, L-ST MV Stereotactic Breast Biopsy - LT, Non-Vac Assist ***TRADITIONAL** 19102, 77031, 10022, 19295, 90772, A4550, 99000, L-US MV US Guided Breast Biopsy - LT, Non-Vac Assist ***TRADITIONAL*** 19102, 76942, 10022, 19295, 90772, A4550, 99000, ASPIRATION 10022L-MV RF guided Hip Injection Aspiration - LT 10022, 77002, 27095, Q9949, 90772, A4550, L-US US Guided Cyst Aspiration, Breast; and Fine Needle Asp - LT 19000, 10022, 76645, 76942, 90772, A4550, Puncture Aspiration of cyst of breast; each Additional Cyst US Guided Fine Needle Aspiration (Biopsy) of Thyroid 60001, 76536, 76942, 90772, A4550, ARTHROGRAM 73202LA-LR Shldr CT Arthrogram of Shoulder w/wo con - LT, CT Guided 73202, 23350, Q9949, 90772, A4550, LA-LR Elbow MR Arthrogram of Elbow w/wo con - LT, CT Guided 73223, 24220, Q9949, 90772, A4550, LA-LR Shldr MR Arthrogram of Shoulder w/wo con - LT, CT Guided 73223, 23350, Q9949, Q9952, 90772, A4550, LA-LR Wrist MR Arthrogram of Wrist w/wo con - LT, CT Guided 73223, 25246, Q9949, Q9952, 90772, A4550, LA-LR Ankle MR Arthrogram of Ankle w/wo con, Unilat, CT Guided 73723, 27648, Q9949, Q9952, 90772, A4550, LA-LR Hip MR Arthrogram of Hip w/wo con, Unilat, CT Guided 73723, 27095, Q9949, Q9952, 90772, A4550, LA-LR Knee MR Arthrogram of Knee w/wo con, Unilat, CT Guided 73723, 27370, Q9949, Q9952, 90772, A4550, LA-MV Shldr CT Arthrogram of Shoulder w/wo con - LT, RF Guided 73202, 23350, Q9949, 90772, A4550, LA-MV Elbow MR Arthrogram of Elbow w/wo con, Unilat RF Guided 73223, 24220, Q9949, Q9952, 90772, A4550, LA-MV Shldr MR Arthrogram of Shoulder w/wo con - LT, RF Guided 73223, 23350, Q9952, Q9949, 90772, A4550, LA-MV Wrist MR Arthrogram of Wrist w/wo con - LT, RF Guided 73223, 25246, Q9949, Q9952, 90772, A4550, LA-MV RF Arthrogram of Sacroiliac Iliac Joint - LT (eg Pain Mgmt) 73542, 27096, Q9949, 90772, A4550, LA-MV Ankle MR Arthrogram of Ankle w/wo con, Unilat, RF Guided 73723, 27648, Q9949, Q9952, 90772, A4550, LA-MV Hip MR Arthrogram of Hip w/wo con, Unilat, RF Guided 73723, 27095, Q9949, Q9952, 90772, A4550, LA-MV Knee MR Arthrogram of Knee w/wo con, Unilat, RF Guided 73723, 27370, Q9949, Q9952, 90772, A4550, LA-MV RF Arthrogram of Shoulder - LT ***TRADITIONAL*** 73040, 23350, Q9949, 90772, A4550, LA-MV RF Arthrogram of Elbow - LT ***TRADITIONAL*** 73085, 24220, Q9949, 90772, A4550, LA-MV RF Arthrogram of Wrist -LT (1..3 Inj 25246) ***TRADITIONAL*** 73115, 25246, Q9949, 90772, A4550, LA-MV RF Arthrogram of Hip - LT ***TRADITIONAL*** 73525, 27095, Q9949, 90772, A4550, LA-MV RF Arthrogram of Knee - LT ***TRADITIONAL*** 73580, 27370, Q9949, 90772, A4550, LA-MV RF Arthrogram of Ankle - LT ***TRADITIONAL*** 73615, 27648, Q9949, 90772, A4550, MYELOGRAM LR Myelogr CT Myelogram C-Spine, CT Guidance, Lumbar Puncture 72126, 62284, Q9949, 90772, A4550, 77012, LR Myelogr CT Myelogram T-Spine, CT Guidance, Lumbar Puncture 72129, 62284, Q9949, 90772, A4550, 77012, LR Myelogr CT Myelogram L-Spine, CT Guidance, Lumbar Puncture 72132, 62284, Q9949, 90772, A4550, 77012, MV Myelogr CT Myelogram C-Spine, RF Guidance, Lumbar Puncture 72126, 62284, Q9949, 90772, A4550, 77002, 72240, MV Myelogr CT Myelogram T-Spine, RF Guidance, Lumbar Puncture 72129, 62284, Q9949, 90772, A4550, 77002, 72255, MV Myelogr CT Myelogram L-Spine, RF Guidance, Lumbar Puncture 72132, 62284, Q9949, 90772, A4550, 77002, 72265, MV RF Myelogram C-Spine, Lumbar Puncture ***Traditional*** 72240, 62284, Q9949, 90772, A MV RF Myelogram T-Spine, Lumbar Puncture ***Traditional*** 72255, 62284, Q9949, 90772, A MV RF Myelogram L-Spine, Lumbar Puncture ***Traditional*** 72265, 62284, Q9949, 90772, A MV RF Myelogram Complete Spine, Lumbar Puncture ***Traditional*** 72270, 62284, Q9949, 90772, A4550 EXAMS_ Page 1/5 SORTED - NUMERIC
2 CT CT guided epidural inj, blood or clot patch 62273, 62270, 77012, 36410, 62273, A CT Head w/ con 70460, Q9949, 36000, A CT Head w/wo con 70470, Q9949, 36000, A O CT Orbits, Sella or posterior fosa 70480, T CT Temp Bones 70480, O CT Orbits, sella or posterior fossa w/ con 70481, 76376, Q9949, 36000, A T CT Temp Bones w/ con 70481, 76376, Q9949, 36000, A O CT Orbits, sella or posterior fossa w/wo con 70482, 76376, Q9949, 36000, A T CT Temp Bones w/wo con 70482, 76376, Q9949, 36000, A F CT Maxillofacial (maxilla, mandible) 70486, S CT Sinus 70486, F CT Maxillofacial (maxilla, mandible) w/ con 70487, 76376, Q9949, 36000, A S CT Sinus w/ con 70487, 76376, Q9949, 36000, A F CT Maxillofacial (maxilla, mandible) w/wo con 70488, 76376, Q9949, 36000, A S CT Sinus w/wo con 70488, 76376, Q9949, 36000, A CT Neck 70490, CT Neck w/ con 70491, 76376, Q9949, 36000, A CT Neck w/wo con 70492, 76376, Q9949, 36000, A CT Angio Head w/wo con 70496, Q9949, 76376, 36000, A CT Angio Neck w/wo con 70498, Q9949, 76376, 36000, A CT Chest 71250, C CT Chest w/ con 71260, Q9949, 76376, 36000, A CAP CT Chest/Abd/Pel w/ con 71260, 74160, 72193, Q9949, 76376, 36000, A CT Chest w/wo con 71270, Q9949, 76376, 36000, A CAP CT Chest Abd & Pelvis w/wo con 71270, 74170, 72194, Q9949, 76376, 36000, A CT Angio Chest w/wo con 71275, Q9949, 76376, 36000, A CT Cervical Spine 72125, CT C-Spine w/ con (Cervical Spine) 72126, Q9949, 76376, 36000, A CT Cervical Spine w/wo con 72127, Q9949, 76376, 36000, A CT Thoracic Spine 72128, CT Thoracic Spine w/ con 72129, Q9949, 76376, 36000, A CT Thoracic Spine w/wo con 72130, Q9949, 76376, 36000, A CT Lumbar Spine 72131, CT Lumbar Spine w/ con 72132, Q9949, 76376, 36000, A CT Lumbar Spine w/wo con 72133, Q9949, 76376, 36000, A CT Angio Pelvis w/wo con 72191, Q9949, 76376, 36000, A CT Pelvis 72192, CT Pelvis w/ con 72193, 76376, Q9949, 36000, A CT Pelvis w/wo con 72194, 76376, Q9949, 36000, A L-Elbow CT Elbow - LT 73200, L-Finger CT Finger - LT 73200, L-ForArm CT Forearm (Radius / Ulna) - LT 73200, L-Hand CT Hand - LT 73200, L-Shldr CT Shoulder - LT 73200, L-UprArm CT Upper Arm (Humerus) - LT 73200, L-Wrist CT Wrist CT Upper Arm (Humerus) - LT 73200, EXAMS_ Page 2/5 SORTED - NUMERIC
3 CT - Cont'd 73201L-Elbow CT Elbow w/ con - LT 73201, 76376, Q9949, 36000, A L-Finger CT Finger w/ con - LT 73201, 76376, Q9949, 36000, A L-ForArm CT Forearm (Radius / Ulna) w/ con - LT 73201, 76376, Q9949, 36000, A L-Hand CT Hand w/ con - LT 73201, 76376, Q9949, 36000, A L-Shldr CT Shoulder w/ con - LT 73201, 76376, Q9949, 36000, A L-UprArm CT Upper Arm (Humerus) w/ con - LT 73201, 76376, Q9949, 36000, A L-Wrist CT Wrist w/ con - LT 73201, 76376, Q9949, 36000, A L-Elbow CT Elbow w/wo con - LT 73202, 76376, Q9949, 36000, A L-Finger CT Finger w/wo con - LT 73202, 76376, Q9949, 36000, A L-ForArm CT Forearm (Radius/Ulna) w/wo con - LT 73202, 76376, Q9949, 36000, A L-Hand CT Hand w/wo con - LT 73202, 76376, Q9949, 36000, A L-Shldr CT Shoulder w/wo con - LT 73202, 76376, Q9949, 36000, A L-UprArm CT Upper Arm (Humerus) w/wo con - LT 73202, 76376, Q9949, 36000, A L-Wrist CT Wrist w/wo con - LT 73202, 76376, Q9949, 36000, A CT Upr Extremity w/ con, Angio 73206, Q9949, 76376, 36000, A L-Ankle CT Ankle - LT 73700, L-Foot CT Forefoot - LT 73700, L-Hip CT Hip - LT 73700, L-Knee CT Knee - LT 73700, L-LwrLg CT Lower Leg - LT 73700, L-Thigh CT Thigh - LT 73700, L-Ankle CT Ankle w/ con - LT 73701, 76376, Q9949, 36000, A L-Foot CT Forefoot w/ con - LT 73701, 76376, Q9949, 36000, A L-Hip CT Hip w/ con - LT 73701, 76376, Q9949, 36000, A L-Knee CT Knee w/ con - LT 73701, 76376, Q9949, 36000, A L-LwrLg CT Lower Leg w/ con - LT 73701, 76376, Q9949, 36000, A L-Thigh CT Thigh w/ con - LT 73701, 76376, Q9949, 36000, A L-Ankle CT Ankle w/wo con - LT 73702, 76376, Q9949, 36000, A L-Foot CT Forefoot w/wo con - LT 73702, 76376, Q9949, 36000, A L-Hip CT Hip w/wo con - LT 73702, 76376, Q9949, 36000, A L-Knee CT Knee w/wo con - LT 73702, 76376, Q9949, 36000, A L-LwrLg CT Lower Leg w/wo con - LT 73702, 76376, Q9949, 36000, A L-Tight CT Tight w/wo con - LT 73702, 76376, Q9949, 36000, A CT Lower Ext w/ con, Angio 73706, Q9949, 76376, 36000, A CT Abdomen 74150, P CT Abdomen/Pelvis 74150, 72192, CT Abdomen w/ con 74160, Q9949, 76376, 36000, A P CT Abdomen/Pelvis w/ con 74160, Q9949, 72193, 76376, 36000, A CT Abdomen w/wo con 74170, Q9949, 76376, 36000, A P CT Abdomen w/wo con, Pelvis w/ con ONLY 74170, Q9949, 72193, 76376, 36000, A PP CT Abdomen/Pelvis w/wo con 74170, Q9949, 72194, 76376, 36000, A U CT UROGRAM, Axial abdomen w/wo con 74170, 72194, 76376, Q9949, 36000, A CT Abdomen w/wo con, Angio 74175, Q9949, 76376, 36000, A CT Angio Aorta with Runoff 75635, Q9949, 76376, 36000, A4550 EXAMS_ Page 3/5 SORTED - NUMERIC
4 MR MR Orbit / Face / Neck w/ con 70542, Q9952, 36000, A MR Orbit / Face / Neck w/wo con 70543, Q9952, 36000, A A MR Angiography, COW w/ con 70545, Q9952, 36000, A V MR Venography, Head, w/ con 70545, Q9952, 36000, A A MR Angiography, COW, w/wo con 70546, Q9952, 36000, A V MR Venography, Head; w/wo con 70546, Q9952, 36000, A MR Brain w/ con 70552, Q9952, 36000, A MR Brain w/wo con 70553, Q9952, 36000, A MV IAC MR IAC`s w/wo con 70553, Q9952, 36000, A MV Pituit MR Pituitary w/wo con 70553, Q9952, 36000, A MR Chest w/ con 71551, Q9952, 36000, A MR Chest w/wo con 71552, Q9952, 36000, A BP MR BRACHIAL PLEXUS 71552, Q9952, 36000, A MR Cervical Spine w/ con 72142, Q9952, 36000, A MR Thoracic Spine 72146, MR Thoracic Spine w/ con 72147, Q9952, 76376, 36000, A MR Lumbar Spine 72148, MR Lumbar Spine w/ con 72149, 76376, Q9952, 36000, A MR Cervical Spine w/wo con 72156, Q9952, 36000, A MR Thoracic Spine w/wo con 72157, Q9952, 76376, 36000, A MR Lumbar Spine w/wo con 72158, 76376, Q9952, 36000, A MR Pelvis w/ con 72196, Q9952, 36000, A MR Pelvis w/wo con 72197, Q9952, 36000, A L-ForArm MR Forearm (Radius / Ulna) w/ con - LT 73219, Q9952, 36000, A L-Hand MR Hand w/ con - LT 73219, Q9952, 36000, A L-UprArm MR Upper Arm (Humerus) w/ con - LT 73219, Q9952, 36000, A L-ForArm MR Forearm (Radius/Ulna) w/wo con - LT 73220, Q9952, 36000, A L-Hand MR Hand w/wo con - LT 73220, Q9952, 36000, A L-UprArm MR Upper Arm (Humerus) w/wo con - LT 73220, Q9952, 36000, A L-Elbow MR Elbow w/ con - LT 73222, Q9952, 36000, A L-Finger MR Finger w/ con - LT 73222, Q9952, 36000, A L-Shldr MR Shoulder w/ con - LT 73222, Q9952, 36000, A L-Wrist MR Wrist w/ con - LT 73222, Q9952, 36000, A L-Elbow MR Elbow w/wo con - LT 73223, Q9952, 36000, A L-Finger MR Finger w/wo con - LT 73223, Q9952, 36000, A L-Shldr MR Shoulder w/wo con - LT 73223, Q9952, 36000, A L-Wrist MR Wrist w/wo con - LT 73223, Q9952, 36000, A L-Foot MR Forefoot w/ con - LT 73719, Q9952, 36000, A L-LwrLg MR Lower Leg (Tibia / Fibula) w/ con - LT 73719, Q9952, 36000, A L-Thigh MR Femur (Thigh) w/ con - LT 73719, Q9952, 36000, A L-Foot MR Forefoot w/wo con - LT 73720, Q9952, 36000, A L-LwrLg MR Lower Leg (Tibia / Fibula) w/wo con - LT 73720, Q9952, 36000, A L-Thigh MR Femur (Thigh) w/wo con - LT 73720, Q9952, 36000, A L-Ankle MR Ankle (Hindfoot) w/ con - LT 73722, Q9952, 36000, A L-Hip MR Hip w/ con - LT 73722, Q9952, 36000, A L-Knee MR Knee w/ con - LT 73722, Q9952, 36000, A4550 EXAMS_ Page 4/5 SORTED - NUMERIC
5 MR - Cont'd 73723L-Ankle MR Ankle (Hindfoot) w/wo con - LT 73723, Q9952, 36000, A L-Hip MR Hip w/wo con - LT 73723, Q9952, 36000, A L-Knee MR Knee w/wo con - LT 73723, Q9952, 36000, A MR Abdomen w/ con 74182, Q9952, 36000, A MR Abdomen w/wo con 74183, Q9952, 36000, A L-MV MR Breast Unilateral w/wo con - LT 77058, Q9952, 36000, A4550, 76350, C-MV MR Breast/Chest Bilateral; w/wo con 77059, Q9952, 76376, 76350, 71552, 36000, A MV MR Breast Bilateral, w/wo con 77059, Q9952, 76376, 76350, 36000, A N-MV MR Breast Bilateral w/o con 77059, MRA Neck (Carotids) 70547, 76350, MRA Neck (Carotids) w/ con 70548, 76350, 76376, Q9952, 36000, A MRA Neck (Carotids) w/wo con 70549, 76350, 76376, Q9952, 36000, A MRA Chest w/wo con 71555, Q9952, 76350, 36000, A MV MRA Pelvis w/wo con 72198, Q9952, 76350, 36000, A MRA Upr Ext, w/wo con 73225, MRA Low Ext w/wo con 73725, Q9952, 76350, 36000, A MRA Abdomen w/wo con 74185, Q9952, 76350, 36000, A4550 U/S US Duplex Scan Lower Ext Arteries (Complete Bilateral) 93925, L US Duplex Scan Lowwr Ext Arteries - LT 93926, US Duplex Scan Upper Ext Arteries (Bilateral) 93930, L US Duplex Scan Upper Ext Arteries - LT 93931, US HysteroSonogram / SonohySterography (SIS) 76831, 58340, A4550 HESTERO MV RF Hysterosalopingogram 74740, Q9949, 58340, 36000, A4550 MISC Ductogram or Galactogram, Breast, Bilateral 19030, 77053, G0204, 36000, A L Ductogram or Galactogram, Breast - LT 19030, 77053, G0206, 36000, A L MG Diagnostic Mammo - LT ***Monarch CalOptima ONLY*** 77055, MG Diagnostic Mammo; Bilateral ***Monarch CalOptima ONLY*** 77051, MG Screening mammo, Bilateral ***Monarch CalOptima ONLY*** 77052, MV RF guided epidural inj, blood or clot patch 62273, 62270, 77002, 36410, 62273, A MV RF Cervical / Thoracic Diskogram, each level 72285, MV RF LUMBAR Diskogram, each level 72295, MV RF IVP, drip and/or bolus techniques 74415, Q9949, 36000, A MV RF Cystogram 74430, 58340, Q9949, 36000, A MV RF Retro Cystourethrogram 74450, 58340, Q9949, 36000, A MV RF VCUG 74455, 58340, Q9949, 36000, A MV Cervic RF Spine Cineradiography/Videofluoroscopy; CERVICAL Complement 76125, MV Lumbar RF Spine Cineradiography/Videofluoroscopy; LUMBAR Compl Flex/Ext 76125, US Abdomen, Retroperitoneal (eg, renal, aorta, nodes) 76775, US OB 1st trimester (14 wks), Fetal & Mat Eval 76801, T US Pelvic (Complete) Trans-Vaginal & Trans-Abdominal 76856, EXAMS_ Page 5/5 SORTED - NUMERIC
CPT CODES. Ph: (307) Fax: (307) CATSCAN IV Contrast: 87.00
Ph: (307) 382-4282 Fax: (307) 382-4291 CPT CODES CATSCAN IV Contrast: 87.00 74150 Abdomen w/o contrast $ 809.00 74160 Abdomen w/ contrast $1175.00 w/ contrast: $1262.00 74170 Abdomen w_w/o contrast $1324.00
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
We Accept Care Credit
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ADI Procedure Codes. August 2016 Revised April 2017 Page 1 of 7 ADI Procedure Codes
Code Description 70450 CT Head without contrast 70460 CT Head with contrast 70470 CT Head with & without contrast 70480 CT Orbit, et al without contrast 70481 CT Orbit, et al with contrast 70482 CT Orbit,
RADIOLOGY (Management)
ULTRASOUND BETA SCAN/ U/S ORBITAL 1600 Daily U/S WHOLE ABDOMEN (Abd + Pelvis) 1200 Daily U/S PELVIS 1200 Daily U/S ABDOMEN 1200 Daily U/S BREAST 1800 Daily U/S FOLLICULAR STUDY 3000 Daily U/S FOLLICULAR
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RADIOLOGY TESTS SONOGRAPHY,COLOR DOPPLER 3D/4D ANAMOLY SCAN 3D/4D ANAMOLY SCAN TWINS 3D/4D USG PELVIS ABDOMEN & PELVIS USG ABDOMEN UPPER USG ANKLE JOINT (LEFT) USG ANKLE JOINT (RIGHT) USG B SCAN BREAST
05/02/ CPT Preauthorization Groupings Effective May 2, Computerized Tomography (CT) Abdomen 6. CPT Description SEGR CT01
Computerized Tomography (CT) 6 & 101 5 Upper Extremity 11 Lower Extremity 12 Head 3 Orbit 1 Sinus 2 Neck 4 7 Cervical Spine 8 Thoracic Spine 9 Lumbar Spine 10 Colon 13 CPT Preauthorization Groupings CPT
AIM 2014 CPT Radiology & Cardiac Codes Requiring Review
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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,
ABDOMEN ABDOMEN - 1 VIEW ABDOMEN - 2 VIEWS ABDOMEN - 3 VIEWS OR MORE ABDOMEN - OBSTRUCTION SERIES INCLUDING CHEST
cpt listing Group NPI #1477551653 January 2019 GENERAL X-RAY HEAD & NECK 70030 EYE LOCAL FOREIGN BODY 70110 MANDIBLE - MIN 4 VIEWS 70130 MASTOIDS - 3 VIEWS 70150 FACIAL BONES - MIN 3 VIEWS 70160 NASAL
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
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Radiological / Imaging Services Fee Schedule Provider Specialty 093
CODE MOD Description 70250 TC RADIOLOGIC EXAM SKULL $18.30 $18.30 7/1/2012 71010 TC RADIOLOGIC EXAM, CHEST $11.41 $11.41 7/1/2012 71020 TC RADILOGICAL EXAM CHEST TWO VIEWS FRONTAL/LATERAL $15.76 $15.76
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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
AMERICAN IMAGING MANAGEMENT
2010 BCBS of Georgia CPT Codes With Grouper Numbers Computerized Tomography (CT) CPT Description Abdomen 74150 CT abdomen; w/o contrast 6 74160 CT abdomen; with contrast 74170 CT abdomen; w/o contrast
Managed Physical Network, Inc.
MPN DC FEE SCHEDULE EVALUATION AND MANAGEMENT 99201 New Patient Exam; Problem Focused $50.00 99202 New Patient Exam; Expanded $50.00 99203 New Patient Exam; Detailed $50.00 99204 New Patient Exam; Comprehensive
Stroke / CVA TIA Trauma Dizziness Headaches. Acoustic Neuroma Syrinx Visual Change Vascular Lesions (AVM) Elevated Prolactin Vertigo Bell s palsy
Head Brain Alzheimer s Mental Status Change Confusion Dementia Memory Loss Dizziness Headaches MRI Brain w/o 70551 Tumor / Mass / Cancer Cranial Nerve Lesions HIV Infection Suspected MS Neurofibromatosis
CT HEAD OR BRAIN WITHOUT AND WITH CONTRAST Computerized Tomography Advanced
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