GUIDELINES FOR Advanced Imaging Studies
Locations Herrin Hospital Memorial Hospital of Carbondale St. Joseph Memorial Hospital 201 S 14th Street Herrin, IL 62948 618.942.2171 ext 35400 General Radiography* CT Interventional Radiology MRI NUCLEAR MEDICINE PET Ultrasound 405 W Jackson Street Carbondale, IL 62902 618.549.0721 ext 65679 General Radiography* CT Interventional Radiology MRI NUCLEAR MEDICINE PET Ultrasound 2 S Hospital Drive Murphysboro, IL 62966 618.684.3156 ext 55550 General Radiography* Bone Density CT MRI Ultrasound Centralized Scheduling 855.457.0100 ext 68130 FAX 618.529.0692 ext 67558 2 sih.net/imaging
BENTON Benton Professional Building 203 Bailey Lane Benton, IL 62812 618.439.3160 ext 68111 General Radiography* Ultrasound HERRIN Herrin Logan Primary Care 405 Rushing Drive Herrin, IL 62948 618.993.3300 ext 68509 General Radiography* Bone Density *General Radiology is walk-in, but all other diagnostic procedures must be scheduled in advance. CARBONDALE Center for Medical Arts 2601 W Main Street Carbondale, IL 62901 618-549-5361 x25227 or 25229 General Radiography* Monday-Friday, Bone Density Monday Friday, CT Monday-Friday, Ultrasound Monday-Friday, Ultrasound WEST FRANKFORT Miners Memorial Health Center 2553 Ken Gray Boulevard West Frankfort, IL 62896 618.932.2155 ext 4 General Radiography* Monday- Friday, Bone Density Monday-Friday, West Frankfort Logan Primary Care 502 W Saint Louis Street West Frankfort, IL 62896 618.937.3400 ext 35711 General Radiography* Monday-Friday, sih.net/imaging 1
Abdomen/ Pelvis Study ContraST AAA (Acute) CT None W/O Contrast CPT Code: 74150 AAA (Non-Acute) W/O Contrast CPT Code: 74177 Adrenal Mass CT IV Only W & W/O Contrast CPT Code: 74170 Abdomen Diverticulitis, Pain, (CT) IV & W Contrast CPT Code: 74177 Colitis, Cancer Staging, Abdomen Oral & Pelvis Appendicitis CT Abd. IV Contrast W Contrast only CPT Code: 74177 & Pelvis Oral Hematuria CT IV Contrast W & W/O Contrast CPT Code: 74178 Urogram Hypervascular Liver Mass MRI IV Only W & W/O Contrast CPT Code: 74183 Abdomen Renal Mass (Confirmed) CT IV Only W & W/O CPT Code: 74170 Abdomen 2 sih.net/imaging
Abdomen/Pelvis Continued ContraST Study Renal Stone, Painful CT Abd No Contrast W/O Contrast CPT Code: 74176 Hematuria & Pelvis Pancreatic Mass (suspected) CT IV Contrast W & W/O Contrast CPT Code: 74170 Abdomen Pelvic Pain-Female US Pelvis non-ob CPT Code: 76856 US US TV non-ob CPT Code: 76831 MRI IV Contrast W & W/O Contrast CPT Code: 72197 CT IV Contrast W Contrast CPT Code: 72193 Pelvic Pain-Male CT Pelvis IV & W & W/O Contrast CPT Code: 72194 CT Pelvis IV W & W/O Contrast CPT Code: 72197 Prostatitis CT Pelvis IV W Contrast only CPT Code: 72193 Prostate/BPH/Cancer MRI Pelvis IV Contrast W & W/O Contrast CPT Code: 72197 Renal Arteries CTA IV Contrast W & W/O Contrast CPT Code: 74175 Abdomen Renal Donor CTA IV contrast W & W/O Contrast CPT Code: 74174 Renal Donor Testicles US first, IV Contrast Scrotum CPT Code: 76870 then MRI IV Contrast W & W/O Contrast CPT Code: 72197 sih.net/imaging 3
Brain & Head Study ContraST Acute Bleed CT No Contrast W/O Contrast CPT Code: 70450 Alzheimers MRI No Contrast W/O Contrast CPT Code: 70551 Aneurysm MRA No Contrast W/O Contrast CPT Code: 70544 Aneurysm CTA IV Contrast With Contrast CPT Code: 70496 Base of Skull MRI IV Contrast W & W/O Contrast CPT Code: 70553 Cranial Nerve MRI IV Contrast W & W/O Contrast CPT Code: 70553 Dementia (Under age 50) MRI No Contrast W/O Contrast CPT Code: 70551 Dementia (Over age 50) MRI IV Contrast W & W/O Contrast CPT Code: 70553 ENT Dizziness MRI IV Contrast W/O Contrast CPT Code: 70551 Headaches (Acute) CT No Contrast W/O Contrast CPT Code: 70450 Chronic headache more than MRI IV Contrast W & W/O Contrast CPT Code: 70553 1 day, patient over age 50 Chronic headache more than MRI No Contrast W/O Contrast CPT Code: 70551 1 day, patient under age 50 Hemorrhage (Non-Acute) MRI IV Contrast W & W/O Contrast CPT Code: 70553 Hydrocephalus MRI IV Contrast W & W/O Contrast CPT Code: 70553 (Normal Pressure) IAC MRI IV Contrast W & W/O Contrast CPT Code: 70553 Infection/Meningitis MRI IV Contrast W & W/O Contrast CPT Code: 70553 4 sih.net/imaging
Brain & Head Continued MRI better than CT for chronic headaches with atypical symptoms such as numbness, weakness, etc. Study ContraST Multiple Sclerosis/ MRI IV Contrast W & W/O Contrast CPT Code: 70553 Demyelinating Disease Pituitary Tumors MRI IV Contrast W & W/O Contrast CPT Code: 70553 Seizures (New Onset) MRI IV Contrast W & W/O Contrast CPT Code: 70553 Seizures or Epilepsy (Chronic) MRI No Contrast W/O Contrast CPT Code: 70551 Sella Tursica MRI IV Contrast W & W/O Contrast CPT Code: 70553 Stroke (Acute) CT First No Contrast W/O Contrast CPT Code: 70450 MRI No Contrast W/O Contrast CPT Code: 70551 Brain Attack Stroke (Non Acute > 72 hours) MRI IV Contrast W & W/O Contrast CPT Code: 70553 Syncope (Acute or Urgent) CT No Contrast W/O Contrast CPT Code: 70450 Syncope (Chronic) MRI No Contrast W/O Contrast CPT Code: 70551 Subarachnoid Bleed CT No Contrast W/O Contrast CPT Code: 70450 Trauma CT No Contrast W/O Contrast CPT Code: 70450 Tumor/Mets MRI IV Contrast W & W/O Contrast CPT Code: 70553 Venous Sinus Thrombosis MRI IV Contrast W & W/O Contrast CPT Code: 70553 (Suspected) MRV W & W/O Contrast CPT Code: 70546 sih.net/imaging 5
Chest Study ContraST Brachial Plexus MRI Chest IV Contrast W & W/O Contrast CPT Code: 71552 MRI Upper Ext IV Contrast W & W/O Contrast CPT Code: 73220 Calcium Scoring CT Heart No Contrast W/O Contrast CPT Code: 75571 Coronary Artery/Pulmonary CTA Heart IV Contrast With Contrast CPT Code: 75572 Vein Evaluation Interstitual Lung Disease CT No Contrast W/O Contrast CPT Code: 71250 (Fibrosis) Mass or Nodule (New) CT IV Contrast With Contrast CPT Code: 71260 Mass or Nodule (Follow up) CT No Contrast W/O Contrast CPT Code: 71250 Pulmonary Embolus CTA IV Contrast With Contrast CPT Code: 71275 Dissection CTA IV Contrast With Contrast CPT Code: 71275 6 sih.net/imaging
Musculoskeletal Study ContraST Arthrogram Elbow MRI IV Contrast With Contrast CPT Code 73222 Arthrogram Knee MRI IV Contrast With Contrast CPT Code: 73722 Arthrogram Hip MRI IV Contrast With Contrast CPT Code: 73722 Arthrogram Shoulder MRI IV Contrast With Contrast CPT Code: 73222 Arthrogram Wrist MRI IV Contrast With Contrast CPT Code: 73222 sih.net/imaging 7
Musculoskeletal Continued Study ContraST Lower Extremity (Muscular, MRI No Contrast Bone, Fracture, Plantar Fasciitis) Ankle, Knee, Toe, Hip Joint W/O Contrast CPT Code: 73721 Foot, Thigh No Joint W/O Contrast CPT Code: 73718 Lower Extremity (Cellulitis, MRI IV Contrast Osteomyelitis, Necrotizing Faciitis or mass) Ankle, Knee, Toe Joint W & W/O Contrast CPT Code: 73723 Foot, Thigh, Tibula, Fibula No Joint MRI W & W/O Contrast CPT Code: 73720 Lower Extremity (Aterial/Venous) CTA IV Contrast With Contrast CPT Code: 73706 Lower Extremity (Bone) CT W & W/O Contrast CPT Code: 73700 Upper Extremity (Muscular, MRI No Contrast Bone, or Fracture) Elbow, Finger, Shoulder, Wrist Joint MRI W/O Contrast CPT Code: 73221 Hand, Humerus, Forearm No Joint MRI W/O Contrast CPT Code: 73218 Upper Extremity (Cellulitis, MRI IV Contrast Osteomyelitis, Necrotizing Fasciitis or mass) Elbow, Finger, Shoulder, Wrist Joint MRI W & W/O Contrast CPT Code: 73223 Hand, Humerus, Forearm No Joint MRI W & W/O Contrast CPT Code: 73220 Upper Extremity (Arterial/Venous) CTA IV Contrast With Contrast CPT Code: 73206 Upper Extremity (Bone) CT No Contrast W/O Contrast CPT Code: 73200 8 sih.net/imaging
Neck, Sinus, Skull, Base & Orbit CT and MRI are interchangeable in the head and neck. CT has disadvantage of radiation and contrast while MRI does not show bony structures as well. On occasion, both may be necessary. Study ContraST Carotid Stenosis Carotid No Contrast CPT Code: 93880 Duplex (Screening) CTA IV Contrast W & W/O Contrast CPT Code: 70498 (Diagnosis) Cavernous Sinus MRI IV Contrast W & W/O Contrast CPT Code: 70553 sih.net/imaging 9
Neck, Sinus, Skull, Base & Orbit Continued Study ContraST Facial (Soft Tissue) CT IV Contrast W Contrast CPT Code: 70487 MRI W & W/O Contrast CPT Code: 70543 Facial (Trauma/Bone) CT No Contrast W/O Contrast CPT Code: 70486 Larynx CT IV Contrast W Contrast CPT Code: 70491 MRI W & W/O Contrast CPT Code: 70543 Neck (Blood Flow) CTA IV Contrast W Contrast CPT Code: 70498 Neck (Mass/Soft Tissue) CT IV Contrast W Contrast CPT Code: 70491 MRI W & W/O Contrast CPT Code: 70543 Optic (Nerve) MRI IV Contrast W & W/O Contrast CPT Code: 70553 Orbit-(Soft tissue) CT IV Contrast W & W/O Contrast CPT Code: 70482 MRI W & W/O Contrast CPT Code: 70543 Orbits-(Trauma/Bone) CT No Contrast W/O Contrast CPT Code: 70480 Salivary Gland CT IV Contrast W & W/O Contrast CPT Code: 70492 Sinusitis CT No Contrast W/O Contrast CPT Code: 70486 Squamous Cancer CT IV Contrast W & W/O Contrast CPT Code: 70492 Temporal Bone CT No Contrast W/O CPT Code: 70480 TMJ MRI No Contrast W/O Contrast CPT Code: 70336 Vocal Cord Paralysis CT IV Contrast W & W/O Contrast CPT Code: 70492 10 sih.net/imaging
Spine Study ContraST Cervical (Disc disease, pain, MRI No Contrast W/O Contrast CPT Code: 72141 radiculopathy, trauma) Cervical (Trauma/Fracture CT No Contrast W/O Contrast CPT Code: 72125 or bone) Cervical (Tumor, Infection, MS MRI IV Contrast W & W/O Contrast CPT Code: 72156 Syrinx, Transverse Myelitis) Thoracic (Disc disease, pain, MRI No Contrast W/O Contrast CPT Code: 72146 radiculopathy, trauma, pre-kyphoplasty) Thoracic (Trauma/Fracture CT No Contrast W/O Contrast CPT Code: 72128 or bone) Thoracic (Tumor, Infection, MS MRI IV Contrast W & W/O Contrast CPT Code: 72157 Syrinx, Transverse Myelitis) Lumbar (Disc HNP disease, MRI No Contrast W/O Contrast CPT Code: 72148 pain, radiculopathy, trauma, pre-kyphoplasty Lumbar (Trauma/Fracture CT No Contrast W/O Contrast CPT Code: 72131 or bone) Lumbar (Tumor, Infection, MRI IV Contrast W & W/O Contrast CPT Code: 72158 MS Syrinx, Transverse Myelitis, pre-kyphoplasty sih.net/imaging 11
Best Modality MRI is best for: Joint, Soft Tissue Injury or Infection Arthrogram Brachial Plexus Brain Tumor or Metastases Cervical Non Trauma IAC s Lumbar Non Trauma Multiple Sclerosis Parkinson s Pituitary/Sella/Orbits Thoracic Non Trauma Characterization of known liver masses Biliary Imaging Female Pelvis Hypervascular liver lesions PET/CT is best for: Cancer Follow-Up Cancer Staging/Restaging CT is best for: Abdominal Aortic Aneurysm Brain/Head Trauma C-Spine Trauma Calcium Scoring Facial Bones/Orbit Trauma Interstitial Lung Disease Intracranial hemorrhage Lung Nodule Abdominal & Pelvic Pain Pulmonary Embolism Renal Mass/Stone Sinus Soft Tissue Neck Carotid/Renal Artery (CTA) Pancreatic Mass Ultrasound is best for: RUQ Pain Pelvic Mass/Pain (female) Evaluation of Pregnancy Thyroid 12 sih.net/imaging
Considerations when ordering an MRI study: An MRI unit uses strong magnetic forces to create an image, as opposed to radiation (CT, X-Ray) or sound waves (Ultrasound). As the magnetic field is always on in an MRI scanner, great care must be taken from a safety standpoint to provide for the safety of patients being scanned. All patients go through a multistep screening process to make sure that implants, clips, stimulators, etc., that they may have are determined to be safe before entering the magnet. In general, the following are considered unsafe for scanning in a 3 T MRI: All Pacemakers and Defibrillators Star-Edwards Heart Valves Neurostimulator systems and Bone stimulators Cochlear implants Tissue expanders Aneurysm clips (Sugita clips are considered safe), all others must be researched Stents must be researched individually (some can be scanned immediately, but this varies by vendor) For 1.5 T MRI units, the following are considered unsafe: Star-Edwards Heart Valves Cochlear implants Tissue expanders Some Pacemakers and Defibrillators are 1.5 T MRI safe Some Neurostimulator systems and Bone stimulators are 1.5 T MRI safe Most stents are 1.5 T MRI safe, but must be researched The industry accepted resource/ clearinghouse for determining device safety is available at www.mrisafety.com. This source along with vendor websites are used to determine device safety if the patient does not have documentation at the time of screening. The above are guidelines and certainly not all inclusive. As MRI is considered a high risk study in terms of patient safety, every effort is made to determine the patient s safety status prior to undertaking any MRI study. sih.net/imaging 13
13 St. Louis, MO 125min from Carbondale Benton Professional 50Building 618-439-3160 57 50 Miners Memorial Health Center 618-932-2155 Logan Primary Care 618-937-3400 64 Mt. Vernon 45 64 Herrin Hospital 618-942-2171 Logan Primary Care 618-993-3300 St. Joseph Memorial Hospital 618-684-3156 51 Herrin West Frankfort Murphysboro Carbondale Benton Marion 34 45 Memorial Hospital of Carbondale 618-549-0721 Center for Medical Arts 618-549-5361 57 146 45 34 24 Cape Girardeau, MO 72min from Carbondale Paducah, KY 78min from Carbondale Imaging Services Offers: X-Ray (walk-in service) CT MRI Ultrasound Interventional Radiology Bone Density Nuclear Medicine PET/CT All services are not available in all locations. Imaging Services Centralized Scheduling 855.457.0100 The information provided in this guide is not intended to be a substitute for a licensed radiologist s recommendation. The material provided is strictly an informational guideline for the most probable imaging study ordered. Specific questions should be directed to a staff radiologist. Our radiologists may recommend an alternative study based on a patient s clinical history and diagnosis provided by the referring physician. 2014