MRI ANATOMICAL GUIDE Please include BUN Creatinine levels of all patients 60 and older or with H/O Renal Failure. Lab work is current within 3 months.
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1 Head & Neck Brain Alzheimer's Dz Stroke/CVA No MRI Brain w/o Mental Status Change Confusion Dementia Memory Loss Suspected MS Tumor/mass/Cancer Seizures Cranial Nerve Lesions H Infection/ Abscess TIA Trauma Dizziness Headaches Cerebral Palsy Epilepsy Syrinx Vasculitis Vascular Lesions (AVM) Neurofibromatosis Visual Change IAC protocol Vestibular Schwannoma Vertigo Hearing Loss, IAC Mass Bell's palsy Pituitary Protocol Pituitary Lesion Elevated Prolactin MRA Brain Aneurysm, family hx TIA No MRA Brain w/o Anuerysm Stroke/CVA MRA Neck Bruit Abnormal doppler or MRA Neck w/ & w/o Stroke / CVA Dissection TIA Syncope MRA Arch and Great Stroke / CVA TIA MRA Neck w/ & w/o Vessels Bruit/ Stenosis Dissection MRV Brain Venous Thrombosis No MRV w/o Orbits (includes whole Trauma No MRI Orbits/Face/Neck/ w/o brain - plus thin cuts Vision Loss Diplopia MRI Orbits/ Face/ Neck thru the orbits) Graves Disease w/ & w/o Neck Exopthalmos / Proptosis Vascular Lesions Pseudotumor Optic Neuritis Infection MRI Orbits / Face/Neck Pain Vocal Cord Paralysis w/ & w/o MRI Brain w/ & w/o
2 Area of Concern Chest Body Part Tumor / Mass / Cancer / Mets Description by CPT Code* CPT Code Brachial Plexus Brachial Plexus Injury MRI Chest / Mediastinum Nerve Avulsion w/& w/o MRA Aorta Abdominal Aortic Dissection MRA Aorta w/ & w/o contrast MRA Chest Excluding cardiac myocardium MRA Chest w/ & w/o contrast Breast Breast MRI Breast Bilateral w/wo contrast Newly diagnosised cancer Evaluate response to chemo Abdomen and Pelvis Mediastinum Abdomen: General Abdomen: Liver MRCP: Billary Pancreas Personal History of BC BRCA 1 or 2 Gene High risk screnning Implant Integrity/Rupture Tumor / Mass / Cancer / Mets Abdominal Pain Post embolization Hemangioma Hepatoma Billary Obstruction Stones Pancreatitis Pancreas Mass Cholangiocarcinoma Dense breasts Palpable lump w/abnormal US or mammographic findings Hepatitis Cirrhosis Increased LFT's Jaundice Abdomenal enzymes Increased LFT's Painless jaundice Ampulla evaluation No MRI Abdomen w/o (MRCP) MRA Abdomen PSC (primary sclerosing) cholangitis) Renal artery stenosis Mesenteric Arterial MRA Abdomen w/ & w/o contrast Hypertension Ischemia MRI Chest / Mediastinum w/& w/o MRI Abdomen w/ & w/o MRI Abdomen w/ & w/o
3 Abdomen and Pelvis MRA Pelvis Femoral Arteries (proximal) MRA Pelvis w/ & w/o contrast Continued Pelvis: General Abscess MRI Pelvis w/ & w/o Pain Decubitus Ulcer Pelvis: Uterus Fibroid Pre/Post Fibroid Embolization Adenomyosis Infertility Pelvis: Ovaries Ovarian Mass Endometrioma Bony Pelvis/ Pelvis/Hip Fracture Trauma Pain Muscle/Tendon Tear No MRI - Pelvis w/o contrast Septic Arthritis MRI - Pelvis w/ & w/o contrast Musculoskeletal Extremity: Non Joint Fracture Muscle / Tendon / Ligament No MRI - Non Joint w/o Forearm Stress Fracture Tear Upper Extremity Humerus Lower Extremity Lower Leg/Calf MRI - Non Joint w/ & w/o Abscess Myositis Femur/Thigh Ulcer Morton's Neuroma Upper Extremity Hand Tumor/Mass/Mets Lower Extremity Foot (ankle/hind foot, Cellulitis Soft tissue Tumor/Mass midfoot, forefoot) Faclitis Mets Extremity: Joint Arthritis Meninscal Tear No MRI - Non Joint w/o Upper Avascular Necrosis (AVN) Muscle Tear Upper Extremity Shoulder Stress Fracture Ligament Tear Lower Extremity Wrist Internal Derangement Cartilage Tear Elbow Pain Ostochondritis Dissecans Labral Tear (OCD) Lower Abscess Inflammatory Arthritis MRI - Joint w/ & w/o contrast Hip - includes pelvis Ulcer Upper Extremity 73223
4 Musculoskeletal Knee Cellulitis Septic Arthritis Lower Extremity continued Ankle (includes distal, tibia & tibia & fibula thru base of metatarsals) Fascitis Myositis Tumor/Mass/Meets MRA Upper Extremity Subclavian Tenderness MRA Upper Extremity w/ & w/o Redness, swelling MRA Lower Extremity (Run off) Peripheral vascular disease MRA Lower Exremity w/ & w/o Spinal Column Spine: Cervical Arm/Shoulder Pain Disc Herniation No Numbness Radiculopathy Neck Pain Degenerative Disease MRI Cervical Spine w/o Syrinx Myelopathy Discitis Spine: Thoracic Back pain Trauma Degenerative disc disease Compression Fracture - Spine: Lumbar Disc Herniation (no hx of malignancy) Radiculopathy Discitis Post-op Fusion Myelopathy Syrinx Compression Fracture - (w/hx of malignancy) Demyelinating Disease Back, Leg pain Sciatica No MRI Lumbar Spine w/o Degenerative Disease Disc Herniation Spondylolisthesis Spinal Stenosis Radiculopathy Compression Fracture - Trauma (no hx of malignancy) MRI Cervical Spine w/ & w/o No MRI Thoracic Spine w/o MRI Thoracic Spine w/ & w/o Discitis Post-Op-Hx of Back Surgery MRI Lumbar Spine w/ & w/o
5 Area of Concern Musculoskeletal Arthrography MR Body Part Sacrum Sacral Insufficiency Fracture No MRI Sacrum wo Wrist Arthrogram SacralIliitis MRI Sacrum w/ & w/o TFCC tear Scaphoid nonunion Intercarpal Ligaments Soft tissue ganglia MR Upper Ext joint w/ Injection - Wrist Rad exam - wrist Elbow Arthrogram MR Upper Ext joint w/ Loose body Internal derangement Injection - Elbow Rad exam - Elbow Shoulder Arthrogram MR Upper Ext joint w/ Labral tear RCT Injection - Shoulder Synovitis Adhesive capsulitis Rad exam - Shoulder Hip Arthrogram Labral tear MR Lower Ext joint w/ Injection - Hip Rad exam - Hip Knee Arthrogram MR Lower Ext joint w/ Recurrent meniscal tearq Loose bodies Injection - Knee post op Chondromalacia Rad exam - Knee Ankle Arthrogram Loose body OCD MR Lower Ext joint w/ Injection - Ankle Rad exam - Ankle This is for reference only. These are the protocol standards for Desert Medical Imaging. Information subject to change. ** Radiologist Injects Directly into Joint. Screening BUN and Creatinine labs are not required.
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
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