RADIOLOGY NOMENCLATURE-2001 PROJECT

Transcription

1 Head and Neck XR- Cisternography XR- Eye for foreign body detection XR- Mandible XR- Mastoids XR- Internal auditory meati XR- Facial bones XR- Nasal Bones XR- Dacryocystography, nasolacrimal duct XR- Optic foramina XR- Orbits XR- Paranasal sinuses XR- Sella turcica XR- Skull XR- Temporomandibular joint, open and closed mouth, unilateral XR- Temporomandibular joint, open and closed mouth, bilateral XR- Temporomandibular joint arthrography, unilateral MRI-Temporomandibular joint XR- Cephalogram, orthodontic XR- Orthopantogram / Panoramic view XR- Neck soft tissues XR- Pharynx or larynx, including fluoroscopy and/or magnification technique XR- Salivary gland for calculus XR- Sialography CT- Head or brain: without contrast material CT- Head or brain: with contrast material CT- Head or brain: without contrast material, followed by contrast material(s) and further sections CT- Orbit, sella, or posterior fossa or outer, middle, or inner ear: without contrast material CT- Orbit, sella, or posterior fossa or outer, middle, or inner ear: with contrast material(s) CT- Orbit, sella, or posterior fossa or outer, middle, or inner ear: without contrast material(s), followed by contrast material(s) and further sections CT- Maxillofacial area: without contrast material CT- Maxillofacial area: with contrast material CT- Soft tissue neck: without contrast material CT- Soft tissue neck: with contrast material CT- Soft tissue neck: without contrast material followed by contrast material(s) further sections CT- Dentascan CT- Petrous bone MRI- Orbit, face and neck, without contrast material(s) MRI- Orbit, face and neck, with contrast material(s) MRI- Orbit, face and neck, without contrast material(s), followed by contrast material(s) and further sequences MRI Angiography- Head, without contrast materials MRI Angiography- Head, with contrast material(s) MRI Angiography- Head, without contrast material(s), followed by contrast material(s) and further sequences MRI Angiography- Neck, without contrast material(s) MRI Angiography- Neck, with contrast material(s) MRI Angiography- Neck, without contrast material(s) followed by contrast material(s) and further sequences MRI- Brain (including brain stem): without contrast material MRI- Brain (including brain stem): with contrast material(s) MRI- Brain (including brain stem): without contrast material, followed by contrast material(s) and further sequences 15 Chest XR- Chest, single view, frontal or lateral XR -Chest, two views, frontal and lateral XR- Chest, two views, frontal and lateral with apical lordotic procedure XR- Chest, two views, frontal and lateral, with fluoroscopy XR- Chest, special views (eg, lateral decubitus, Bucky studies) XR- Bronchography XR- Ribs, unilateral XR- Ribs, unilateral, two views, including posteroanterior chest, minimum of three views XR- Ribs, bilateral XR- Sternum XR- Sternoclavicular joint or joints, minimum of three views CT- Thorax: without contrast material CT- Thorax: with contrast material(s) CT- Thorax: without contrast material followed by contrast material(s) and further sections MRI- Chest, without contrast material(s) MRI- Chest, with contrast material(s) MRI- Chest, without contrast material(s), followed by contrast material(s) and further sections MRI- Angiography, chest, with or without contrast material(s) 15 1/9

2 Spine and Pelvis XR- Entire Spine, survey study, AP and lateral XR- Spine, cervical: AP & lateral XR- Spine, cervical: minimum of four views XR- Spine, cervical: complete, including oblique and flexion and/or extension studies XR- Spine, thoracolumbar, standing XR- Spine, thoracic, two views XR- Spine, thoracic, three views including Swimmer's view of the cervico-thoracic junction XR- Spine, thoracolumbar, AP and lateral XR- Spine, scoliosis study, including supine and erect sudies, with or without lateral bending views XR- Spine, lumbosacral, two or three views XR- Spine, lumbosacral, minimum of four views including oblique views XR- Spine, lumbosacral: complete, including flexion and/or extension views CT- Cervical spine: without contrast material CT- Cervical spine: with contrast material CT- Cervical spine: without contrast material, followed by contrast material(s) and further sections CT- Spine, thoracic: without contrast material CT- Spine, thoracic: with contrast material(s) CT- Spine, thoracic: without contrast material, followed by contrast material(s) and further sections CT- Spine, lumbar: without contrast material CT- Spine, lumbar: with contrast material(s) CT- Spine, lumbar: without contrast material followed by contrast material(s) and further sections MRI- Spinal canal and contents, cervical: without contrast material MRI- Spinal canal and contents, cervical: with contrast material(s) MRI- Spinal canal and contents, thoracic: without contrast material MRI- Spinal canal and contents, thoracic: with contrast material(s) MRI- Spinal canal and contents, lumbar: without contrast material MRI- Spinal canal and contents, lumbar: with contrast material(s MRI- Spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences: cervic MRI- Spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences: thorac MRI- Spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences: lumba MRI- Angiography, spinal canal and contents, with or without contrast material(s) Total Body MRI XR- Pelvis and both hips, one or two views CT- Pelvis: without contrast material CT- Pelvis: with contrast material CT- Pelvis: without contrast material, followed by contrast material(s) and further sections MRI- Pelvis, without contrast material(s) MRI- Pelvis, with contrast material(s) MRI- Pelvis, without contrast material(s), followed by contrast material(s) and further sequences MRI- Angiography, pelvis, with or without contrast material(s) XR- Sacroiliac joints XR- Sacrum and coccyx, minimum two views XR- Myelography, cervical XR- Myelography, thoracic XR- Myelography, lumbosacral XR- Myelography, entire spinal canal XR- Diskography, cervical or thoracic or lumbar, one level XR- Diskography, cervical or thoracic or lumbar, each additional level XR- Spinal puncture, diagnostic under fluoroscopic control 10 2/9

3 Upper extremities XR- Clavicle XR- Scapula XR- Shoulder, one view XR- Shoulder, complete, minimum of two views XR- Shoulder, arthrography XR- Acromioclavicular joints, bilateral, with or without weighted distraction XR- Humerus, minimum of two views XR- Elbow, two views XR- Elbow, arthrography XR- Forearm, two views XR- Wrist, two views XR- Wrist, complete, minimum of three views XR- Wrist, arthrography XR- Hand, two views XR- Hand, complete, minimum of three views XR- Finger(s), minimum of two views CT- Upper extremity: without contrast material CT- Upper extremity: with contrast material CT- Upper extremity: without contrast material, followed by contrast material(s) and further sections MRI- Upper extremity, other than joint, without contrast material(s) MRI- Upper extremity, other than joint, with contrast material(s) MRI- Upper extremity, other than joint, without contrast material(s), followed by contrast material(s) and further sequences MRI- Any joint of upper extremity, without contrast material(s) MRI- Any joint of upper extremity, with contrast material(s) MRI- Any joint of upper extremity, without contrast material(s), followed by contrast material(s) and further sequences MRI- Angiography, upper extremity, with or without contrast material 15 Lower Extremities XR- Hip, unilateral, one view XR- Hip, unilateral, complete, minimum of two views XR- Hips, bilateral, minimum of two views of each hip, including AP view of pelvis XR- Hip, arthrography XR- Hip, during operative procedure XR- Pelvis and hips, infant or child, minimum of two views XR- Sacroiliac joint arthrography XR- Femur, two views XR- nee, AP and lateral XR- nee, complete, including oblique(s), and tunnel, and/or patellar and/or standing views XR- nees, both, standing, AP XR- nee, arthrography XR- Tibia and fibula, two views XR- Ankle, two views XR- Ankle, arthrography XR- Foot, two views XR- Calcaneus, minimum of two views XR- Toe(s), minimum of two views XR- Extremity (during surgery, open reduction and internal fixation) CT- Lower extremity, without contrast material CT- Lower extremity, with contrast material(s) CT- Lower extremity, without contrast material, followed by contrast material(s) and further sections MRI- Lower extremity other than joint, without contrast material(s) MRI- Lower extremity other than joint, with contrast material(s) MRI- Lower extremity, other than joint, without contrast material(s), followed by contrast material(s) and further sequences MRI- Any joint of lower extremity, without contrast material MRI- Any joint of lower extremity, with contrast material MRI- Any joiny of lower extremity, without contrast material(s), followed by contrast material(s) and further sequences MRI- Angiography, lower exttremity, with or without contrast material(s) MR arthrography, any joint 25 3/9

4 Abdomen XR- Abdomen: single AP view (.U.B.) XR- Abdomen, complete, including decubitus and/or erect views XR- Abdomen, complete acute abdomen series including supine, erect, and/or decubitus views, upright PA chest CT- Abdomen: without contrast material CT- Abdomen: with contrast material CT- Abdomen: without contrast material, followed by contrast material(s) and further sections CT- Abdomen and pelvis MRI- Abdomen, without contrast material MRI- Abdomen, with contrast material MRI- Abdomen, without contrast material(s), followed by contrast material(s) and further sequences MRI- Angiography, abdomen, with or without contrast material(s) Peritoneogram (eg after injection of air or contrast)/herniography 10 Gastrointestinal Tract XR- Pharynx and/or cervical esophagus XR- Esophagus XR- Swallowing function, pharynx and/or esophagus, with cineradiography and/or video XR- Removal of foreign body(s), esophageal, with use of balloon catheter XR- Upper GI tract, barium studies with or without UB XR- Upper GI tract, air contrast, with specific high density barium, effervescent agent, with or without glucagon XR- Upper GI tract, air contrast, with specific high density barium, effervescent agent, with or without glucagon: with small bowel follow-through XR- Small bowel, includes multiple serial films XR- Small bowel, includes multiple serial films, via enteroclysis tube XR- Colon, barium enema (single contrast), with or without UB XR- Colon, barium enema, air contrast with specific high density barium, with or without glucagon XR- Barium enema, therapeutic, for reduction of intussuception or other intraluminal obstruction (eg meconium ileus) XR- Defecography XR- Cholangiography and/or pancreatography: intraoperative XR- Cholangiography and/or pancreatography: postoperative T-tube cholangiography XR- Cholangiography, percutaneous, transhepatic XR- Postoperative biliary duct stone removal, percutaneous via T-tube tract, basket or snare (eg, Burhenne technique) XR- Endoscopic catheterization of the biliary ductal system, interpretation XR- Endoscopic catheterization of the pancreatic ductal system, interpretatio XR- Combined endoscopic catheterization of the biliary and pancreatic ductal systems, ERCP interpretatio MRI- Cholangiopancreatography (MRCP) XR- Introduction of long gastrointestinal tube (eg, Miller-Abbott), including multiple fluoroscopies and films, nasoduodenal or nasojejunal tube insertion for feeding purpose XR- Percutaneous placement of gastrostomy or coecostomy tube XR- Intraluminal dilatation of strictures and/or obstructions (eg, esophagus) Stent placement in esophagus or colon under radiological guidance 60 Urinary Tract XR- Urography (pyelography), intravenous, with UB, with or without tomography XR- Urography (pyelography), retrograde, interpretation XR- Urography, antegrade, (pyelostogram, nephrostogram, ileal conduit loopogram) XR- Cystography XR- Vasography, vesiculography, or epididymography, interpretation XR- Corpora cavernosography, contrast and manometric studies following papaverine injection XR- Urethrocystography, retrograde XR- Urethrocystography, voiding XR- Renal cyst study, translumbar, contrast visualization and alcohol injection XR- Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection, percutaneous, D-J ureteral stenting XR- Dilation of nephrostomy, ureter, or urethra stricture XR- Percutaneous renal access for urological procedures MR- Urography Transrectal biopsy, prostate 15 Gynecological and Obstetrical XR- Hysterosalpingography XR- Transcervical catheterization of fallopian tube Perineogram (eg, vaginogram, for sex determination or extent of anomalies) 10 Heart MRI- Heart, imaging for morphology, without contrast material MRI- Heart, imaging for morphology, with contrast material MRI- Heart, imaging for function, with or without morphology, complete study MRI- Heart, imaging for function, with or without morphology, limited study MRI- Heart, imaging for velocity flow mapping CT- Calcium score Multislice CT coronography 25 4/9

5 Aorta and Arteries XR- Aortography, thoracic, procedure XR- Aortography, thoracic, interpretation XR- Aortography (Digital Subtraction Angiography), Flush aortogram, procedure XR- Aortography (Digital Subtraction Angiography), Flush aortogram, interpretatiion XR- Aortography, abdominal, procedure XR- Aortography, abdominal, interpretation XR- Aortography, abdominal, plus bilateral iliofemoral lower extremity, procedure XR- Aortography, abdominal, plus bilateral iliofemoral lower extremity,interpretation XR- Angiography, cervicocerebral, catheter, including vessel origin, procedure XR- Angiography, cervicocerebral, catheter, including vessel origin, interpretation XR- Angiography, brachial, retrograde, procedure XR- Angiography, brachial, retrograde, interpretation XR- Angiography, external carotid, unilateral, selective, procedure XR- Angiography, external carotid, unilateral, selective, interpretation XR- Angiography, external carotid, bilateral, selective, procedure XR- Angiography, external carotid, bilateral, selective, interpretation XR- Angiography, carotid, cerebral, unilateral, procedure XR- Angiography, carotid, cerebral, unilateral, interpretation XR- Angiography, carotid, cerebral, bilateral, procedure XR- Angiography, carotid, cerebral, bilateral, interpretation XR- Angiography, carotid, cervical, unilateral, procedure XR- Angiography, carotid, cervical, unilateral, interpretation XR- Angiography, carotid, cervical, bilateral, procedure XR- Angiography, carotid, cervical, bilateral, interpretation XR- Angiography, vertebral, cevical, and/or intracranial, procedure XR- Angiography, vertebral, cevical, and/or intracranial, interpretation XR- Angiography, spinal selective, procedure XR- Angiography, spinal selective, interpretation XR- Angiography, extremity, unilateral, procedure XR- Angiography, extremity, unilateral, interpretation XR- Angiography, extremity, bilateral, procedure XR- Angiography, extremity, bilateral, interpretation XR- Angiography, renal, unilateral, selective (including flush aortogram), procedure XR- Angiography, renal, unilateral, selective (including flush aortogram), interpretation XR- Angiography, renal, bilateral, selective (including flush aortogram), procedure XR- Angiography, renal, bilateral, selective (including flush aortogram), interpretation XR- Angiography, visceral, selective or supraselective, (with or without flush aortogram), procedure XR- Angiography, visceral, selective or supraselective, (with or without flush aortogram), interpretation XR- Angiography, adrenal, unilateral, selective, procedure XR- Angiography, adrenal, unilateral, selective, interpretation XR- Angiography, adrenal, bilateral, selective, procedure XR- Angiography, adrenal, bilateral, selective, interpretation XR- Angiography, pelvic, selective or supraselective, procedure XR- Angiography, pelvic, selective or supraselective, interpretation XR- Angiography, pulmonary, unilateral, selective, procedure XR- Angiography, pulmonary, unilateral, selective, interpretation XR- Angiography, pulmonary, bilateral, selective, procedure XR- Angiography, pulmonary, bilateral, selective, interpretation XR- Angiography, pulmonary by nonselective catheter or venous injection, procedure XR- Angiography, pulmonary by nonselective catheter or venous injection, interpretation XR- Angiography, internal mammary, procedure XR- Angiography, internal mammary, interpretation XR- Angiography, bronchial unilateral or bilateral, procedure XR- Angiography, bronchial unilateral or bilateral, interpretation XR- Angiography, selective, each additional vessel studied after basic examination, procedure XR- Angiography, selective, each additional vessel studied after basic examination, interpretation XR- Angiography, arteriovenous shunt (eg, dialysis patient), procedure XR- Angiography, arteriovenous shunt (eg, dialysis patient), interpretation CT- Spiral, CT angiography with image post-processing (MIP and SSD), Biphasic and Triphasic spiral CT, Virtual CT endoscopy CT with rectal contrast or fleet enema, CT enteroclysis, CT cisternography, CT myelography, CT arthrography, CT sialography, CT urography 22 5/9

6 Veins and Lymphatics XR- Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt) XR- Splenoportography XR- Venography, extremity, unilateral XR- Venography, extremity, bilateral XR- Venography, caval, inferior XR- Venography, caval, superior XR- Venography, renal,unilateral, selective XR- Venography, renal,bilateral, selective XR- Venography, adrenal, unilateral, selective XR- Venography, adrenal, bilateral, selective XR- Venograohy, sinus or jugular, catheter XR- Venography, superior sagittal sinus XR- Venography, epidural XR- Venography, orbital XR- Percutaneous transhepatic portography with or without hemodynamic evaluation XR- Dialysis fistula - direct puncture and fistulogram XR- Hepatic venography, wedged or free, with or without hemodynamic evaluation XR- Lymphangiography, bipedal MR- Venography XR- Venous sampling through catheter, with or without angiography 60 Transcatheter Procedures XR- Transcatheter therapy, embolization, any method XR- Transcatheter therapy, infusion, any method (eg, thrombolysis or cyst/tumor ablation, chemoembolization, vasopressine or papaverine infusion) XR- Angiogram through existing catheter for follow-up study for transcatheter therapy, embolization or infusion XR- Exchange of a previously placed arterial catheter during thrombolytic therapy XR- Percutaneous nephrostomy, unilateral XR- Percutaneous nephrostomy, bilateral XR- Percutaneous dilation of ureteral stricture with D-J stent insertion, one side XR- Percutaneous celiac plexus block or ablation XR- Percutaneous placement of IVC filter XR- Intravascular ultrasound XR- Carotid artery stent placement, percutaneous XR- Endovascular repair of aortic dissection XR- Placement of prosthesis for endovascular repair of aortic aneurysm XR- Transcatheter introduction of intravascular stent(s), (non-coronary vessel), percutaneous and/or open: initial vessel XR- Transcatheter placement of an intravascular stent, (non coronary), percutaneous or open: each additional vessel XR- Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, fractured venous or arterial cathet XR- Transluminal balloon angioplasty, renal or visceral or peripheral artery XR- Transcatheter biopsy i.e. Transjugular liver biopsy XR- Transluminal balloon angioplasty, venous (eg, subclavian stenosis) XR- Percutaneous transhepatic biliary drainage or cholecystostomy XR- Percutaneous placement of a metallic stent (non vascular) XR- Change or repositioning of percutaneous tube or drainage catheter XR- Radiological guidance for percutaneous drainage of abscess, or specimen collection (ie, fluoroscopy, ultrasound, or computed tomography), with or without placement of indwelling catheter Transjugular intrahepatic portosystemic shunt (TIPSS) Measurements of pressure gradient in TIPSS, percutaneous XR- Transluminal atherectomy, renal, visceral or peripheral artery XR- Repair of TIPSS shunt without stent placement 60 6/9

7 Other Procedures XR- Fluoroscopy (separate procedure) XR- Radiological assistance, assisting a non-radiologic physician (eg, nephrostolithotomy, ERCP, bronchoscopy, transbronchial biopsy, or others) XR- Needle biopsy or fine needle aspiration, percutaneous, any site XR- Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural, transforaminal epidural, subarachnoid, paravertebral facet joint, paravertebral facet joint nerve or sacroiliac joint), including neurolytic agent destruction XR- Stress or comparative view(s), any joint or bone XR- Radiological supervision and interpretation, percutaneous vertebroplasty, per vertebral body, under fluoroscopic or CT guidance XR- Radiological supervision and interpretation, percutaneous vertebroplasty, per vertebral body, each additional le XR- Nucleolysis under radiological guidance XR- Radiofrequency ablation of tumor, percutaneous XR- Radiofrequency ablation of tumor - each additional lesion XR- Aspiration and/or injection of hepatic, splenic, renal or breast cyst, percutaneous XR- Aspiration and/or injection of hydatid cyst or pancreatic necrosis, percutaneous XR- Bone age studies XR- Bone length studies (orthoroentgenogram, scanogram) XR- Skeletal survey CT- Bone mineral density study, one or more sites XR- Dual energy x-ray absorptiometry (DEXA), bone density study, one or more sites: axial skeleton (eg, hips, pelvis,spine) XR- Dual energy x-ray absorptiometry (DEXA), bone density study, one or more sites: appendicular skeleton (peripheral)(leg, radius, wrist,heel) XR- Fistula or sinus tract study XR- Mammary ductogram or galactogram XR- Mammography, unilateral XR- Mammography, bilateral XR- Screening mammography, bilateral (two view film study of each breast) MRI- Breast, without and/or with contrast material, unilateral MRI- Breast, without and/or with contrast material, bilateral XR- Stereotactic or mammotome localization/guidance for breast biopsy or needle placement) eg, for wire localization or for injection or for biopsy), each lesion XR- Ultrasound guidance for needle placement, breast (eg, for wire localization or for injection or for biopsy), each lesi XR- Radiological examination of surgical specimen XR- Single plane body sections (eg, tomography), other than urography CT- Guidance for stereotactic localization (brain biopsy) CT- Guidance for needle placement (eg, biopsy, aspiration, injection, localization device) CT- Guidance for placement of radiation therapy fields Coronal, sagittal, multiplanar, oblique, 3-dimensional and/or holographic reconstruction of CT, MRI, or other tomographic modali MRI- Spectroscopy MRI- Guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization devic MRI- Bone marrow blood supply MRI- Fetal MRI Aspiration and injection, tendon sheath or calcifications, or ganglion cyst or bone cyst under imaging guidanc Ventriculo-peritoneal shunt series Polysitogram 10 7/9

8 Head and Neck DIAGNOSTIC ULTRASOUND US- Echoencephalography, real-time scan with image documentation (for determination of ventricular size, delineation of cerebral contents and detection of fluid masses or other intracranial abnormalities US- Echography, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real-time scan with image documentation 8 Chest US- Echography, chest, real-time scan with image documentation US- Echography, breast(s), unilateral or bilateral, real-time scan with image documentation 8 Abdomen and Retroperitoneum US- Echography, abdominal, real-time scan with image documentation US- retroperitoneal (eg, renal, aorta, lymph nodes) real-time scan with image documentation US- Echography of transplanted kidney, real-time scan with image documentation 8 Spinal Canal US- Echography, spinal canal and contents 8 Pelvis US- Echography, pregnant uterus, real-time scan with image documentation US- Fetal biophysical profile US- Doppler echocardiography, fetal, cardiovascular system, pulsed wave with spectral display, complete US- Echography, transvaginal US- Echography, pelvic (nonobstetric) real-time scan with image documentation US- Monitoring of ovulation with follow-up US- Transrectal and pelvic US- Transvaginal and pelvic 10 Genitalia US- Echography, scrotum and contents US- Echography, transrectal 8 Extremities US- Echography, extremity, non-vascular, real-time with image documentation 8 Vascular Studies (Doppler Ultrasound) Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, and/or retroperitoneal organs: complete stu Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, and/or retroperitoneal organs: follow-up or limited study Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts: complete study Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts: follow-up or limited study Duplex scan of testicular vessels Duplex scan of penile vessels with papaverine injection Contrast enhanced color Doppler abdominal scan Duplex scan of extracranial arteries: complete bilateral study Duplex scan of extracranial arteries: follow-up or limited study Transcranial Doppler study of the intracranial arteries: complete study Transcranial Doppler study of the intracranial arteries: follow-up or limited study Duplex scan of lower extremity arteries or arterial bypass grafts: complete bilateral study Duplex scan of lower extremity arteries or arterial bypass grafts: follow-up or limited study Duplex scan of upper extremity arteries or arterial bypass grafts: complete bilateral study Duplex scan of upper extremity arteries or arterial bypass grafts: follow-up or limited study Duplex scan of extremity veins including responses to compression and other maneuvers: complete study Duplex scan of extremity veins including responses to compression and other maneuvers: follow-up or limited study Duplex scan, obstetrical 15 Ultrasonic Guidance Procedures US- Guidance for pericardiocentesis US- Guidance for thoracentesis or abdominal paracentesis US- Guided compression repair of arterial pseudo-aneurysm or of arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging US- Guidance for cyst (any location) or renal pelvis aspiration US- Guidance for intrauterine fetal transfusion or cordocentesis US- Guidance for needle biopsy US- Guidance for chorionic villus sampling US- Guidance for amniocentesis US- Guidance for aspiration of ova US- Color Doppler guidance for prostate biopsy and anesthesia infiltration 15 Other Procedures Gastrointestinal endoscopic ultrasound US- Echography, intraoperative 15 8/9

9 DIAGNOSTIC Endocrine System Thyroid uptake Thyroid imaging Thyroid carcinoma metastases imaging: whole body (isotope charged separately) Parathyroid imaging (isotope charged separately) Adrenal imaging, cortex and/or medulla (isotope charged separately) 8 NUCLEAR MEDICINE Hematopietic, Reticuloendothelial and Lymphatic System Bone marrow imaging: whole body Plasma volume, radiopharmaceutical volume dilution technique Red cell volume determination (separate procedure) Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutica Red cell survival study Platelet survival study Lymphatics and lymph glands imaging 8 Gastrointestinal System Liver and spleen imaging: static only Liver and spleen imaging: with vascular flow Hepatobiliary ductal system imaging, including gall bladder, with or without pharmacologic intervention, with or without Salivary gland function study Esophageal motility Gastroesophageal reflux study Gastric emptying study Acute gastrointestinal blood loss imaging Bowel imaging (eg, ectopic gastric mucosa, Meckel localization, volvulus) 5 Musculoskeletal System Bone and/or joint imaging: whole body Bone and/or joint imaging: tomographic (SPECT) 5 Cardiovascular System Non-cardiac vascular flow imaging (ie, angiography, venography) Myocardial perfusion imaging: (planar) single study, at rest or stress (exercise and/or pharmacologic), with or without Myocardial perfusion imaging: tomographic (SPECT), multiple studies, at rest and/or stress (exercise and/or pharmacologic) and Myocardial imaging, infarct avid, planar: qualitative or quantitative Cardiac blood pool imaging, gated equilibrium: multiple studies, wall motion study plus ejection fraction, at rest and stress Cardiac blood pool imaging, (planar), first pass technique: single study, at rest or stress (exercise and/or pharmacologic), wall 10 Respiratory System Pulmonary perfusion imaging, particulate Pulmonary ventilation imaging, aerosol (aerosol kit charged separately) Pulmonary quantitative differential function (ventilation/perfusion) study 10 Nervous System Brain imaging, complete study: tomographic (SPECT)(isotope charged separately) Brain imaging, vascular flow only Cerbrospinal fluid imaging (not icluding introduction of material): cisternography 7 Genitourinary System idney imaging with vascular flow and function study (isotope charged separately) idney imaging: tomographic (SPECT) idney transplant evaluation (isotope charged separately) Ureteral reflux study (radiopharmaceutical voiding cystogram) Testicular imaging, with vascular flow 6 Other Procedures Radiopharmaceutical localization of tumor: whole body (isotope charged separately) Radiopharmaceutical localization of abscess: whole body (isotope charged separately) 8 Therapeutic Radioactive iodine ( 131 ) therapy, up to 10 millicuries Radioactive iodine ( 131 ) therapy, each additional 5 millicuries Radioactive phosphorus (P 32 ), 5 millicuries Radioactive strontium chloride (Sr 89 ), 4 millicuries 30 POSITRON EMISSION TOMOGRAPHY Brain, PET with F-18 DG Cardiac, PET with F-18 DG Total body, PET with F-18 DG PET - CT with F-18 DG 25 9/9