569-73605.pdf CPT List Reformatted 1 3/23/2015 20180116pg1aPROOF.pdf 3:16:06 PM 1 1/18/2018 2:33:18 PM
PET/CT CT/CTA MRI/MRA BONE DENSITY NUCLEAR MEDICINE DIGITAL MAMMOGRAPHY ECHOCARDIOGRAPHY DIGITAL XRAY ULTRASOUND VASCULAR STUDIES RADIATION ONCOLOGY IMRT VASCULAR & INTERVENTIONAL CENTER MRI MRI NUCLEAR Medicine NuclearMEDICINE MRI │ PET │ CT MAMMOGRAPHY Mammography Nuclear PETMedicine PET Mammography CT
Full-Service, All Digital Imaging Network
CT
west covina • POMONA ONTARIO
DIAGNOSTIC RADIOLOGY CPT GUIDE 2018
C
M
Y
CM
MY
CY
CMY
K
X-RAY BONE & JOINTS Bone Age Studies Bone Length Studies (Scanogram/ Orthoroentgenogram) Bone Survey - Skeletal ABDOMEN Abdomen AP and Add'l Oblique and Cone Views Abdomen Complete Acute Abdomen Series Abdomen Complete Incl. Decubitus & Erect Views Abdomen, AP, Single View KUB HEAD, NECK & OROFACIAL BONES Facial Bones Mandible Mastoids Nasal Bones Sinuses/ Paranasal Skull Neck, Soft Tissue Orbits Temporomandibular Joint, Open/Closed, Bilateral CHEST Chest Chest, 2 Views w/ Apical Lordotic Procedure Chest, 2 Views w/ Oblique Projections Chest Special Views Clavicle Complete Ribs, Unilateral Ribs, Bilateral Sternum SPINE Cervical Spine **(6 or more views use CPT 72052) Cervical Spine Complete, Incl Oblique; Flex & Ext Lumbosacral, AP & Lateral Lumbosacral, Bending Views Only Lumbosacral, Complete Incl. Bending Views Sacrum & Coccyx Sacroiliac Joints Spine, Scoliosis Study, Incl. Supine & Erect **(6 or more views use CPT 72084) Spine, Single View, Specify Level (Scoliosis) Thoracic Thoracolumbar Junction SHOULDER, UPPER ARM & ELBOW Acromioclavicular Joint Bilat w/ or w/o Weights Elbow Humerus Scapula Complete Shoulder FOREARM, HAND & FINGERS Fingers Forearm Hand Wrist LOWER LEG, KNEE, ANKLE & FOOT Calcaneus or Heel Foot Ankle Tibia & Fibula Toe(s) Knee Knee, Both, Standing AP PELVIC REGION, HIP & THIGH Femur Hip Unilateral, Incl. AP of Pelvis Hip Bilateral, Incl. AP of Pelvis **(5 v+ use CPT 73523) Pelvis
1v 74010 70422 74020 74018 1v
2v 74019
3v 74021
77072 77073 77075 4v+ 74021
74019
74021
74021
2v 70140
3v 70150 70100 70130 70160 70220 70250
4v+
70120 70210
70110
70260
70360 70200 70330 1v 71045
71035 73000
2v 71046 71047 71047 71046 71100
1v
71120 2v
3v 71048
4v+
71048 71048 71101 71110 71130 3v 72040
71111 4v+ 72050
72052 72100 72120
72100 72120
72110 72114
72081
72220 72200 72082
72202 72082
72083
72070 72080 2v
72072
72074
3v
4v+
73070 73060
73080
72020
1v 73050
73010 73020 1v
1v
73560 73565 1v 73551 73501 72170
73030 2v 73140 73090 73120 73100 2v 73650 73620 73600 73590 73660 73560 2v 73552 73502 73521 72170
3v
4v+
73130 73110 3v
4v+
73630 73610
73562
73564
3v
4v+
73502 73522
73503 73522
ULTRASOUND HEAD/NECK Soft tissues of Head & Neck (Thyroid, Parathyroid, Parotid) 76536 BREAST Breast Complete (Unilateral) 76641 Breast Limited (Unilateral) 76642 CHEST Chest for Pleural Effusion, Fluid and/ or Masses in Chest Wall 76604 ABDOMEN Abdomen (Complete) 76700 Abdomen (Ltd) 1 Org/Quad; F/U; Inguinal Hern; R/O Hern; Groin P 76705 KIDNEY/RENAL Kidney/Renal Complete; Retroperitoneal 76770 PELVIS Pelvic Limited (Non OB); Inguinal Hern; R/O Hern; Groin Pain 76857 Pelvic Complete (Non Obstetric) 76856 Transvaginal (Non Obstetric) 76830 GENITALIA (MALE) Prostate (Non-Transrectal) 76856 Scrotum and Contents (Testicles) 76870 OBSTERICAL OB (1st Trimester <14 Weeks 0 days) 76801 OB (2nd & 3rd Trimester > or = 14 Weeks 0 Days) 76805 OB Limited (Fetal Heartbeat, Placental & Fetal Position) 76815 OB Transvaginal 76817 OB Follow Up (Re-Evaluate Fetal Size & Organ Sys.) 76816 SOFT TISSUE Exam of Upper & Lower Extremities (Complete) 76881 Exam of Upper & Lower Extremities (Limited) 76882 Axilla 76882 Chest Wall (Limited) 76604-52 Pelvic Wall (Retroperitoneal Region, Penis, Perinum) 76857 Buttock 76857 Groin (Hip Groin Region & Peripheral Nerves) 76882 Other Soft Tissue 76999 INFANTS Infant Hips Dynamic (w/ Physician Manipulation) 76885 SPINE Spinal Canal & Contents 76800 VASCULAR ULTRASOUND DUPLEX/DOPPLER VENOUS REFLUX EXTREMITY Duplex extremity veins - Complete Bilateral 93970 Duplex extremity veins - Limited/ Unilateral 93971 ARTERIAL EXTREMITY Duplex Lower Extremities Arteries Complete Bilateral 93925 Duplex Lower Extremity Arteries Limited/ Unilateral 93926 Duplex Upper Extremities Arteries Complete Bilateral 93930 Duplex Upper Extremity Arteries Limited/ Unilateral 93931 ABI 93922 CAROTID Duplex Extracranial Arteries Complete Bilateral 93880 AORTA Abdominal/ Aorta - Screening AAA 76706 KIDNEY/ RENAL Renal Arterial Complete 93975 DIGITAL MAMMOGRAPHY CHEST Screening, Bilateral; All Views (formerly G0202) 77067 Diagnostic, Bilateral; All Views (formerly G0204) 77066 Diagnostic, Unilateral; All Views (formerly G0206) 77065 Spot Compression, Bilateral (formerly G0204) 77066 Spot Compression, Unilateral (formerly G0206) 77065 Implants (formerly G0204) 77066 DEXA (BONE DENSITOMETRY) Dual-Energy X-Ray (DEXA) 77080 ECHOCARDIOGRAPHY Echocardiography; Transthoracic, Complete 93306
Rev 01162018
10226 Lakewood Blvd, Downey, CA 90241 1700 W. West Covina Pkwy, West Covina, CA 91790 3115 E. Guasti Road, Ontario, CA 91761 1555 N. Orange Grove Ave, Pomona, CA 91767 1183 E. Foothill Blvd, Ste 235, Upland, CA 91786 1433 N. Hollenbeck Ave, Ste 105, Covina, CA 91722
© Copyright | Centrelake 2018
(909) 242-7300 (626) 773-7717 (562) 287-7200 Scheduling Fax (909) 784-3760 www.centrelakeimaging.com
569-73605.pdf CPT List Reformatted 1 3/23/2015 20180116pg2aPROOF.pdf 3:16:06 PM 1 1/18/2018 2:36:17 PM
PET/CT CT/CTA MRI/MRA BONE DENSITY NUCLEAR MEDICINE DIGITAL MAMMOGRAPHY ECHOCARDIOGRAPHY DIGITAL XRAY ULTRASOUND VASCULAR STUDIES RADIATION ONCOLOGY IMRT VASCULAR & INTERVENTIONAL CENTER MRI MRI NUCLEAR Medicine NuclearMEDICINE MRI │ PET │ CT MAMMOGRAPHY Mammography Nuclear PETMedicine PET Mammography CT
Full-Service, All Digital Imaging Network
CT
west covina • POMONA ONTARIO
DIAGNOSTIC RADIOLOGY CPT GUIDE 2018 MRI (MAGNETIC RESONANCE IMAGING) HEAD/ NECK Brain (incl. Brainstem) MR Angio Brain/ Head MR Angio Neck Orbit, Face and/or Neck Temporomandibular Joint(s) MR Venography CHEST Chest Breast Bilateral MR Angio Chest (Excl. Myocardium) Brachial Plexus SPINE/ PELVIS Cervical Spine Lumbar Spine Thoracic Spine Pelvis/SI Joint/ Sacrum/ Coccyx
w/ 70552
w/ & w/o 70553
70548 70542
70549 70543
w/o 71550
70545 w/ 71551
73218 w/o 72141 72148 72146 72195
73219 w/ 72142 72149 72147 72196
70546 w/ & w/o 71552 77059 71555 73220 w/ & w/o 72156 72158 72157 72197
w/o 73218 73221 73718 73721
w/ 73219 73222 73719 73722
w/o 70551 70544 70547 70540 70336
MR Angio Pelvis
C
M
Y
CM
MY
CY
CMY
K
EXTREMITIES Upper Extremity, Other Than Joint Upper Extremity, Any Joint Lower Extremity, Other Than Joint Lower Extremity, Any Joint MR Angio Upper Extremity MR Angio Lower Extremity MR Angio Run-Off (Abdomen to Lower Extr) ABDOMEN Abdomen MR Angio Abdomen MRCP (Abdomen, Liver, Pancreas) CT (COMPUTED TOMOGRAPHY) HEAD/NECK Angiography Head Angiography Neck Head/Brain Maxillofacial Area/Sinus/ TMJ/ Mandible Orbit/Sella/P. Fossa/ Mastoid/ Temporal/ Ear Soft tissue neck CHEST Thorax/Chest Angiography Chest (Non Coronary/ Heart) ABDOMEN Abdomen Angiography Abdomen ABDOMEN & PELVIS (BUNDLED) Abdomen & Pelvis Angiography Abdomen & Pelvis Urogram SPINE/ PELVIS Cervical Spine Lumbar Spine Thoracic Spine Pelvis Angiography Pelvis EXTREMITIES Lower Extremity Upper Extremity Angiography Lower Extremity Angiography Upper Extremity CT Angio Run-Off (Abdomen to Lower Extr)
w/o 74181
w/ 74182
3D 76377 76377
76377 3D
76377 3D
72198
76377
w/ & w/o 73220 73223 73720 73723 73225 73725 73725 x 2 74185 w/ & w/o 74183 74185
3D
76377 76377 76377 x 3 3D
w/
70450 70486 70480 70490 w/o 71250
70460 70487 70481 70491 w/ 71260
w/o 74150
w/ 74160
w/o 74176
w/ 74177 74174
w/o 72125 72131 72128 72192
w/ 72126 72132 72129 72193
w/o 73700 73200
w/ 73701 73201
10226 Lakewood Blvd, Downey, CA 90241 1700 W. West Covina Pkwy, West Covina, CA 91790 3115 E. Guasti Road, Ontario, CA 91761 1555 N. Orange Grove Ave, Pomona, CA 91767 1183 E. Foothill Blvd, Ste 235, Upland, CA 91786 1433 N. Hollenbeck Ave, Ste 105, Covina, CA 91722
w/ & w/o 70496 70498 70470 70488 70482 70492 w/ & w/o 71270 71275 w/ & w/o 74170 74175 w/ & w/o 74178
3D 76377 76377
3D 76377 3D
Wrist (Requires all 3 codes) Elbow (Requires all 3 codes) Shoulder (Requires all 3 codes) Hip (Requires all 3 codes) Knee (Requires all 3 codes) Ankle (Requires all 3 codes) MRI ARTHROGRAPHY (W/ CONTRAST ONLY) Wrist (Requires all 3 codes) Elbow (Requires all 3 codes) Shoulder (Requires all 3 codes) Hip (Requires all 3 codes) Knee (Requires all 3 codes) Ankle (Requires all 3 codes)
Scan 78300 78306 78315 Scan 78707 78708 Scan 78804 78806 78804 Scan 78226 78227 Scan 93015 78472
Material A9503 A9503 A9503 Material A9562 A9562 Material A9556 A9570 A9572 Material A9537 A9537 Material A9500 x 2 A9560
78496 Scan 78014 78013 78070 Scan 78215
Material A9516 A9512 A9500 Material A9541
Scan 78815 78816
Material A9552 A9552
Fluoro 77002 77002 77002 77002 77002 77002
Needle 25246 24220 23350 27093 27370 27648
Scan 73201 73201 73201 73701 73701 73701
Fluoro 77002 77002 77002 77002 77002 77002
Needle 25246 24220 23350 27093 27370 27648
Scan 73222 73222 73222 73722 73722 73722
PET/CT Skull Base to Mid Thigh PET/CT Whole Body (Skull Base to Extremities) CT ARTHROGRAPHY (W/ CONTRAST ONLY)
76377
S8037 or 74181 w/o
NUCLEAR MEDICINE BONE/ JOINT Bone and/or Joint Scan; Limited Bone and/or Joint Scan, Whole Body Bone and/or Joint Scan; 3 Phase Study KIDNEY/ RENAL Renal w/o Pharma Intervention Renal w/ Pharma Intervention (Diuretic/ Lasix) WHOLE BODY Gallium Scan, Whole Body, 2 or More Days Indium Scan, Whole Body, WBC Octreotide Scan HEPATOBILIARY TRACT/GALLBLADDER Hepatobiliary Scan (HIDA Scan) w/o Pharma Hepatobiliary Scan (HIDA Scan) w/ Pharma CARDIOVASCULAR Cardiac Stress Test (4 CPT codes required) 78452 multi study Cardiac Blood Pool Imaging, Gated Equil, Cardiac Blood Pool Imaging, Gated Equil, Single Study Rest, w/ Rt Vent Eject (2nd MUGA Code) THYROID & PARATHYROID Thyroid Uptake, Scan w/ I-123 Capsule, Multiple Thyroid Scan Only Parathyroid Imaging LIVER & SPLEEN Liver-Spleen PET (POSITRON EMISSION TOMOGRAPHY)
76377 3D 76377
74178 w/ & w/o 72127 72133 72130 72194 72191 w/ & w/o 73702 73202 73706 73206 75635
3D
IMPORTANT #1: FOR NUCLEAR, PET & ARTHROGRAPHY STUDIES, PLEASE AUTHORIZE ALL CODES LISTED FOR THAT STUDY. IMPORTANT #2: FOR ALL MRI & CT ANGIOGRAPHY, CT JOINTS & SPINE, PLEASE AUTHORIZE 3D RECONSTRUCTION CODE LISTED FOR THAT STUDY.
76377 3D
76377 76377 76377
*** If the study is not listed on this guide, please call our office for additional assistance. Rev 01162018
© Copyright | Centrelake 2018
(909) 242-7300 (626) 773-7717 (562) 287-7200 Scheduling Fax (909) 784-3760 www.centrelakeimaging.com
