ORDERING GUIDE
00 MISSION, VISION, AND CORE VALUES
Mission To provide compassionate care and superior medical imaging services to patients, providers, and healthcare organizations.
Vision Enhance the wellness of our community through the delivery of high-quality, innovative healthcare.
CoRE Values • Compassion...for everyone • Respect...in every interaction • Excellence...in everything we do
01 WHY THIS GUIDE IS IMPORTANT TO YOU AND YOUR PATIENTS
This ordering guide is meant to assist you when ordering a study with Radiology Ltd. The guide includes common indications as well as recommendations for the most appropriate examination.
Our goal is to provide you and your patients with the most appropriate and complete imaging examination. After the correct order is placed, examinations are further tailored to each patient’s specific condition. Thus, it is very important for the radiologist to be aware of the clinical question or specific condition in question so that the appropriate imaging can be performed.
When ordering an examination please include pertinent history as well as signs or symptoms. Please refrain from ordering “r/o” exams such as “rule out tumor” or “rule out anomaly” unless history and signs/ symptoms are included as well. Feel free to specify a particular entity or condition you would like the Radiologist to comment upon in the report.
In the back of the guide, you will find a list of our contracted insurance and network plans as well as our imaging centers, addresses and phone numbers.
Radiology Ltd. has a Professional Relations Department with field representatives dedicated to serving your needs. If you have any questions or concerns, please contact the Professional Relations Department at (520) 901-6614 or at [email protected].
Thank you, The Physicians and Staff of Radiology Ltd.
02 IMPORTANT CONTACT INFORMATION
CENTRALIZED SCHEDULING NEED HELP OR HAVE QUESTIONS Tel: (520) 733-7226 ABOUT WHAT TO ORDER? Fax: (520) 290-8377 CLINICAL REVIEW STAT Hotline: (520) 545-1919 Tel: (520) 545-1819 Toll Free: (866) 565-2220 Fax: (520) 545-1844 Toll Free Fax: (866) 707-0750
SPECIALTY SCHEDULING BREAST BIOPSY INTERVENTIONAL COORDINATION Tel: (520) 901-6792 Tel: (520) 545-1906, opt. 4 Fax: (520) 545-1848 Fax: (520) 545-1898
BREAST MRI PET / CT Tel: (520) 901-6631 Tel: (520) 545-1906, opt. 3 Fax: (520) 901-6746 Fax: (520) 545-1898
OTHER IMPORTANT NUMBERS AUTHORIZATION VERIFICATION For Supplies: Tel: (520) 901-6767 Tel: (520) 733-4104 Fax: (520) 545-1981 Email: [email protected]
CODING & PRICING HOTLINE RADVISION Tel: (520) 545-1818 Tel: (520) 901-6747 Online Requests: Fax: (520) 901-6634 radltd.com/request-exam-pricing Toll Free Tel: (866) 386-9459 HIPAA HOTLINE Website: radltd.com/for-providers Tel: (520) 545-1969 After Hours Tech Support: Toll Free Tel: (866) 683-2199 Tel: (520) 545-1720
MEDICAL RECORDS TAX ID AND NPI INFORMATION Tel: (520) 545-1822 Radiology Ltd. Tax ID Fax: (520) 326-7989 86-0423896 Online Requests: radltd.com/medical-record-request Radiology Ltd. - Carondelet Tax ID 26-2750704 PATIENT BILLING (for CT, Ultrasound and X-ray only; for MRI use Tel: (520) 296-0278 Radiology Ltd. Tax ID listed above) Secure Online Bill Pay: radltd.com/online-bill-pay Radiology Ltd. Group NPI# 1841261989 PROFESSIONAL RELATIONS Tel: (520) 901-6614 Radiology Ltd. - Carondelet NPI# Fax: (520) 545-1726 03 1528224904 Email: [email protected] TABLE OF CONTENTS
BREAST IMAGING ULTRASOUND High Risk Screening...... 5 General...... 33 Mammo Ordering Decision Tree...... 6 Soft Tissue ...... 35 CPT Codes for Women’s Imaging...... 7 Vascular...... 36 Screening & Diagnostic Mammography...... 8 Musculoskeletal/Joints...... 37 Additional Imaging & Procedures...... 9 Breast MRI Scheduling Checklist...... 10 X-RAY Breast MRI...... 11 General...... 38
CT / CTA INTERVENTIONAL CPT Codes for CT Scans...... 12 Minimally Invasive Diagnostic Procedures...... 41 Lung Screening Ordering...... 13 Pain Management...... 43 General...... 14 Vascular Services...... 45 Head and Spine...... 17 Musculoskeletal...... 19 ICD-10 CODES Specialty...... 20 ICD-10 Codes Notes...... 47
DEXA PREFERRED PROVIDER INFORMATION Bone Densitometry...... 22 Major Insurance Plans...... 49 Major Network Plans...... 49 MRI / MRA CPT Codes for MRI Scans...... 23 IMAGING CENTERS Brain...... 24 Locations...... 50 Spine...... 25 Modality by Location...... 51 Breast...... 26 Chest, Abdomen, and Pelvis...... 27 Musculoskeletal...... 29 MISC. Scheduling Checklist ...... 52 PET / CT RadVision...... 53 PET/CT Scheduling Checklist...... 31 ACR Appropriateness Criteria...... 54 General...... 32 Notes...... 55 Bone Scan...... 32
04
HIGH RISK SCREENING RISK HIGH Recommendations (ACR) Radiology of College American New Riskfor High Screening (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To with or without 3D mammography, especially if other risk factors present are with or without 3D mammography, Annual breast MRI should be considered in addition to digital mammography digital in addition to MRI should be considered breast Annual Annual breast MRI from age 25-30 MRI from breast Annual 25 or 8 years after radiotherapy, whichever is later whichever after radiotherapy, 25 or 8 years Annual breast MRI from diagnosis MRI from breast Annual Digital mammography with or without 3D mammography annually from diagnosis annually from with or without 3D mammography mammography Digital Annual breast MRI from age 25-30 from MRI breast Annual age annually from with or without 3D mammography mammography Digital Digital mammography with or without 3D mammography annually from age 30 annually from or without 3D mammography with mammography Digital • • • • • • • GROUP FOUR GROUP GROUP THREE GROUP GROUP TWOGROUP GROUP ONE GROUP For women with personal histories of breast cancer not included in the above cancer of breast with personal histories women For Personal history of breast cancer diagnosed before age 50 before diagnosed history cancer of breast Personal and dense breasts history cancer of breast Personal Women with a history of chest radiotherapy before age 30 before with a history of chest radiotherapy Women Tyrer-Cuzick calculated lifetime risk of 20% or greater risk of 20% lifetime calculated Tyrer-Cuzick relatives first-degree with a known high risk gene and their untreated Patients The ACR recommends all women, especially black women and those of Ashkenazi of Ashkenazi and those especially black women all women, recommends ACR The age 30, so than risk later no cancer breast for be evaluated should Jewish descent, from high risk screening. can benefit and higher risk can be identified those at that
BREAST IMAGING 05 BREAST IMAGING www.radltd.com 06 annual Return to Return to screening screening NEGATIVE: NEGATIVE: provider approval) mammogram w/ referring w/ referring
Cyst aspiration aspiration Cyst at time of exam at (can be performed (see below) month Order 6 Order BENIGN: follow-up follow-up diagnostic PROBABLY mammogram NO Diagnostic order required order Diagnostic w/breast indicated Extra views needed (call back) Extra views if clinically Diagnostic Diagnostic ultrasound, ultrasound, mammogram per radiologist recommendation: recommendation: per radiologist ± 3D Tomosynthesis (beginning at age 40) at (beginning biopsy SCREENING MAMMOGRAPHY Order breast breast Order SUSPICIOUS: Annual Annual screening screening Negative mammogram biopsy Order breast breast Order SUSPICIOUS: Does the patient have a problem? a problem? have Does the patient mammogram Order diagnostic diagnostic Order Nipple discharge Nipple discharge w/breast ultrasound w/breast (reproducible, single (reproducible, duct, bloody or serous) Surgical Surgical need for need for NEGATIVE: NEGATIVE: to consider consider to consultation consultation ductography YES (see below) ≥30 DIAGNOSTIC STUDY DIAGNOSTIC MAMMOGRAPHY ORDERING DECISION TREE DECISION ORDERING MAMMOGRAPHY years old years Order Order (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To w/ breast w/ breast diagnostic diagnostic ultrasound mammogram mammogram Palpable Palpable lesion / focal pain lesion / focal <30 only breast breast years old years ultrasound ultrasound FRACTURE ASSESSMENT STUDY BIOPSY DEPENDING VARIES CODING PLEASE PROCEDURE. THE ON CODING OUR CONTACT DETAILED A FOR DEPARTMENT EXPLANATION. MRI BREAST SCAN DENSITY BONE (UFE) EMBOLIZATION FIBROID UTERINE ON DEPENDING VARIES CODING CONTACT PLEASE PROCEDURE. THE A FOR DEPARTMENT CODING OUR EXPLANATION. DETAILED 77049 - BILATERAL BREAST MRI BREAST BILATERAL - 77049 77080 - DEXA SCAN VERTEBRAL WITH 77085 - DEXA COMPOSITION BODY DEXA - 76499 For more information on exam codes on exam information more For Coding and Pricing Hotline at (520) 545-1818. (520) at Hotline and Pricing Coding and pricing, please contact the Radiology please contact Ltd. and pricing, CPT CODES for WOMEN’S IMAGING WOMEN’S for CODES CPT all radiology for standards doesnot imply protocol This only. reference is for This change. Information is subject to facilities. (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To INCLUDING CAD INCLUDING INCLUDING CAD INCLUDING INCLUDING CAD INCLUDING TOMOSYNTHESIS TOMOSYNTHESIS TOMOSYNTHESIS *CMS determined that for several reasons related to claims processing systems, Medicare claims systems will be claims systems Medicare systems, claims processing to related reasons several for that *CMS determined to will continue They 2017. calendar year 77065, 77066, and 77067 for claims using CPT codes process unable to 2018. calendar year for adopting the 2017 codes G-codesuse the existing G0206, G0204 and G0202 and anticipate ULTRASOUND DIAGNOSTIC MAMMOGRAPHY DIAGNOSTIC BILATERAL DIAGNOSTIC MAMMOGRAPHY DIAGNOSTIC UNILATERAL SCREENING MAMMOGRAPHY SCREENING 76641 - UNILATERAL COMPLETE UNILATERAL - 76641 LIMITED UNILATERAL - 76642 ALONE AXILLA - 76882 77066 - BILATERAL DIGITAL MAMMOGRAPHY, MAMMOGRAPHY, DIGITAL BILATERAL - 77066 3D BREAST BILATERAL - 77062 77061 - UNILATERAL BREAST 3D BREAST UNILATERAL - 77061 77065 - UNILATERAL DIGITAL MAMMOGRAPHY, DIGITAL UNILATERAL - 77065 77063 - SCREENING BREAST 3D BREAST SCREENING - 77063 77067 77067 - BILATERAL DIGITAL MAMMOGRAPHY,
BREAST IMAGING 07 BREAST IMAGING www.radltd.com 08
CODE 77062 - bilateral 77067-52 76641 - unilateral, complete 76642 - unilateral, limited 77067 77063 77061 77062 77061 - unilateral 77062 - bilateral 77061 - unilateral
PROCEDURE mammogram: personal history cancer -of breast lumpectomy with ultrasound of mass) (identify area (if needed) mammogram (specify baseline or annual exam) mammogram: mammogram Ultrasound with Mammogram mammogram: painmammogram: of pain)(identify area with ultrasound pain) (localized Diagnostic Unilateral screening Unilateral Screening Diagnostic Breast Diagnostic Diagnostic Diagnostic • • • • • • PARAMETERS treatment untreated breast (12 breast untreated months and 1 day since last exam) (12 months and 1 day since last screening exam) localized pain localized Lumpectomy 6 months post surgery post ≤ 3 years Mass Annual after age 40 Pain - localized Pain - discharge Mass, Annual screening of Annual screening • • • • • • • • No fasting required. No deodorant, lotions, Arrive 15 mins prior exam. No fasting required. to
BREAST IMAGING: Screening and Screening IMAGING: BREAST Diagnostic Mammography standards does not imply protocol This only. is for reference This change. is subject Information to facilities. for all radiology TYPE OF EXAM TYPE See below for standard See for below See below for standard See for below standard See for below See below for standard See for below See below for standard See for below See below for standard See for below See below for standard See for below See below for standard See for below Preps: Preps: mammo preps. History Cancer of Breast mammo preps. mammo preps. Preps: Preps: Preps: Tomosynthesis (3D) Tomosynthesis Including CAD Screening Mammography Mammography Screening Screening, Annual Mastectomy Preps: Preps: mammo preps. Tomosynthesis (3D) Tomosynthesis mammo preps. Preps: Preps: Preps: Preps: mammo preps. Bilateral Mammography Bilateral - Symptoms Findings Clinical mammo preps. Preps: Preps: Bilateral, Including CAD Bilateral, Screening Mammography, Mammography, Screening Tomosynthesis (3D) Tomosynthesis Unilateral Mammography Mammography Unilateral mammo preps. Preps: Preps: Ultrasound Under 30 Years of Age - Order of Age Years Under 30 *CMS determined that for several reasons related to claims processing systems, Medicare claims systems will be unable to process claims process will be unable to claims systems Medicare systems, claims processing to related reasons several for that *CMS determined G0202 and G0204 G0206, G-codes existing the use to will continue They 2017. calendar year 77065, 77066, and 77067 for using CPT codes 2018. calendar year for adopting the 2017 codes and anticipate Mammo Preps: Standard powder or perfumes. appointment. to powder along with doctors Bring order insurance cards
CODE number of ducts - 19081 Ultrasound Guided Singular Ultrasound 76942 19000 Guided MultipleUltrasound Same Side 19000 19001 x number of add’l cysts 76942 Stereotactic Guided Stereotactic 77065 - unilateral 77066 - bilateral 77065 - unilateral 76642 - unilateral 77066 - bilateral 76642 - RT 76642 - LT Guided Biopsy - 19085 - 19086 Lesion Additional Biopsy - 19082 Lesion Additional Guided Ultrasound Biopsy - 19083 - 19084 Lesion Additional Magnetic Resonance 77065 - unilateral 76642 - unilateral 77066 - bilateral 76642 - RT 76642 - LT 77065 - unilateral 77066 - bilateral Singular Duct 19030 77053 Multiple Ducts 19030 - x 77054
discharge PROCEDURE aspiration indeterminate lesion / mass post biopsy mammogram +ultrasound: (identify breast and(identify breast describe discharge) : : mammogram short-term follow-up additional exam ±ultrasound discharge : mammogram Left / right cysticLeft / rightLeft Diagnostic Diagnostic Mammogram Ductogram for nipple for Ductogram Diagnostic
• • • • • • •
±Ultrasound PARAMETERS patient must be able to report indicating need aspirationfor imaging previous exam (3-6previous months) back) ( at time of discharge express ductogram) after (preferably consultation) surgical (6 months after previous mammogram) Biopsy indicated on priorBiopsy indicated Unilateral Reproducible Single duct discharge Recommendation of biopsy exam Post Mammography (callMammography Previous ultrasoundPrevious Ductogram
• • • • • • • • • No deodorant, lotions, powder or perfumes. powder Arrive No deodorant, lotions, No fasting required. No fasting required. No deodorant or talcum powder under arms breast or No deodorant or talcum powder No fasting required. or it is deemed appropriate for other reasons. or it is deemed appropriate
BREAST IMAGING: Additional Imaging Additional IMAGING: BREAST Procedures and standards does not imply protocol This only. is for reference This change. is subject Information to facilities. for all radiology or diagnostic mammography, if the patient has dense breasts or diagnostic mammography, 3D mammography may be ordered as an may be adjunct ordered screening 3D mammography to prior to exam. Bring insurance cards along with doctors order to appointment. to along with doctorsprior exam. Bring order to insurance cards See below for standardSee for below See below for standardSee for below See below for standardSee for below See below for standardSee for below See below for standardSee for below TYPE OF EXAM TYPE Indeterminate Lesion Indeterminate Preps: preps. breast Nipple Discharge Preps: mammo preps. Nipple Discharge Preps: Preps: preps. breast Recommendation ofRecommendation Imaging Additional exam)(callback or recall Exam Follow-Up Term Short Preps: mammo preps. Cystic Mass / Lesion Cystic Breast on Previous Found Ultrasound Preps: preps. breast Mammo Preps: Standard 15 mins Preps: Breast Standard Bring insurance cards along with doctors order to appointment. to Arrive along with doctors 30 mins prior exam. Bring order area. to insurance cards
BREAST IMAGING 09 BREAST IMAGING www.radltd.com 10
BREAST IMAGING: IMAGING: BREAST Scheduling MRI ChecklistBreast standards does not imply protocol This only. is for reference This change. is subject Information to facilities. for all radiology
Please fax any additional notes to:
Breast MRI Dept. at (520) 545-1848 Breast biopsy and breast pathology Breast biopsy and breast Breast MRI reports (past 5 years) Breast MRI reports (past Last mammogram reports (past 5 years) mammogram reports (past Last (past 5 years) Breast ultrasound reports Copy of patients insurance card(s) Copy of patients demographics Patient Clinical history / progress notes Clinical history Order for Breast MRI (all are performed MRI (all are performed Order for Breast reports (past 5 years) Bilateral, please do not indicate Rt or Lt) do not indicate Bilateral, please
reports listed below: Radiology Ltd., please include any additional please include any additional Ltd., Radiology If prior imaging studies were not performed at If prior imaging studies
MRI orders: Please include the following with ALL Breast with ALL following include the Please CODE 77049 77049 77049 77049 77049 PROCEDURE (and chest MRI, if necessary) MRI in addition to MRI in addition to protocol” “implant Bilateral breast MRI breast Bilateral MRI breast Bilateral Bilateral breast MRI breast Bilateral MRI breast Bilateral Bilateral breast breast Bilateral • • • • • PARAMETERS chemotherapy leak clinical or indeterminate (radiologist results imaging ) recommendation cancer screening Follow-up for neo-adjuvant for Follow-up Suspected silicone implant lump Palpable Pain evaluation of Further Recent diagnosis of breast of breast Recent diagnosis High cancer risk breast • • • • • • • MRI Breast IMAGING: BREAST standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology Please note: Breast MRI does not replace screening mammography. screening MRI does Breast not replace note: Please (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To TYPE OF EXAM TYPE Follow-up for for Follow-up Chemotherapy Treatment Breast (high risk screening) Breast implants) (silicone Breast standard for See below Preps: MRI preps. breast Breast (indeterminate (indeterminate Breast results) clinical or imaging standard for See below Preps: MRI preps. breast standard for See below Preps: MRI preps. breast standard for See below Preps: MRI preps. breast standard for See below Preps: MRI preps. breast Breast (pre-operative Breast staging) Drink plenty of fluids day before exam, nothing to eat two hours exam, nothing Drink plenty before of fluids day MRI Preps: Breast Standard Arrive makeup. 30 mins metal or eye deodorant, jewelry, hairspray, prior exam. Do not wear to appointment. to exam. Bring insurance card before
BREAST IMAGING 11 CT / CTA www.radltd.com 12 BRAIN W/O CONTRAST 70450 - 70460 - W/CONTRAST 70470 - W/O & W/CONTRAST CERVICAL SPINE W/O CONTRAST 72125 - 72126 - W/CONTRAST 72127 - W/O & W/CONTRAST CHEST W/O CONTRAST 71250 - 71260 - W/CONTRAST 71270 - W/O & W/CONTRAST SPINE THORACIC W/O CONTRAST 72128 - 72129 - W/CONTRAST 72130 - W/O & W/CONTRAST ABDOMEN PELVIS COMBINATION W/O CONTRAST 74176 - 74177 - W/CONTRAST 74178 - W/O & W/CONTRAST SPINE LUMBAR W/O CONTRAST 72131 - 72132 - W/CONTRAST 72133 - W/O & W/CONTRAST CPT CODES for CT for SCANS CODES CPT all radiology for standards does imply protocol This not only. reference is for This change. Information is subject to facilities. (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To ORBIT W/O CONTRAST 70480 - 70481 - W/CONTRAST 70482 - W/O & W/CONTRAST LOWER EXTREMITY LOWER W/O CONTRAST 73700 - 73701 - W/CONTRAST 73702 - W/O & W/CONTRAST UPPER EXTREMITY W/O CONTRAST 73200 - 73201 - W/CONTRAST 73202 - W/O & W/CONTRAST SOFT TISSUE NECK W/O CONTRAST 70490 - 70491 - W/CONTRAST 70492 - W/O & W/CONTRAST MAXILLOFACIAL W/O CONTRAST 70486 - 70487 - W/CONTRAST 70488 - W/O & W/CONTRAST Eligibility not verified. Reasons for ineligibility reported to your office.
If your patient does not meet these requirements, but needs a chest CT scan for another clinical indication, you can order a standard diagnostic chest CT.
. 13 CT / CTA www.radltd.com 14 CODE 70491 71275 74175 71275 71275 71250 71250 71260 71270 PROCEDURE abdomen contrast, high- resolution contrast with contrast CT neck with contrast CTA chest and CTA CTA chest CTA CTA chest CTA CT chest without CT chest with contrast CT chest without CT and chest without • • • • • • • • exam) st gland Lymphadenopathy Mass mass Parotid stone Parotid Submandibular stone Cancer workups Cancer Dysphagia Infection Infection gland of parotid Infection of submandibular Aortic dissection aorticThoracic aneurysm Aortic dissection aorticThoracic aneurysm Pulmonary embolism Shortness of breath Vascular evaluation Asbestosis Bronchiectasis Fibrosis Interstitial lung disease plaques Pleural Sarcoidosis Abnormal chest X-ray COPD Cough Esophageal CA Hemoptysis CA Lung Lymphoma Mass Pain Pneumonia Shortness of breath Tracheal stenosis Lung nodules (follow-up) nodules Lung Lung nodules (1 Lung COMMON REASON FOR EXAM COMMON • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • PART CT / CTA: General CT / CTA: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology BODY BODY See below for standard See for below See below for standard See for below See below for standard See for below See below for standard See for below See below for standard See for below See below for standard See for below Preps: Preps: CT Preps. Contrast Neck Preps: Preps: CT Preps. CTA Chest & Abdomen Chest CTA Preps: Preps: CT Preps. Contrast CTA Chest CTA Preps: Preps: CT Preps. Contrast CTA Chest (PE Study) Chest CTA Preps: Preps: CT Preps. Chest, High Resolution Chest, CT Preps. Contrast Preps: Preps: Chest insurance cards to appointment. Arrive 30 mins before exam. appointment. Arrive to 30 mins before insurance cards Nothing to eat two hours prior to exam. Drink plenty of water. Bring eat two hours prior exam. DrinkNothing to to plenty Preps: of water. CTStandard Contrast of water. Bring insurance cards to appointment. Arrive 30 mins before scheduled appointment. appointment. Arrive to 30 mins before Bring cards insurance of water. Nothing to eat two hours prior to exam. No oral contrast needed. Drink eat two plenty hours prior exam. No oral contrast needed. Nothing to CT to Standard Preps: CODE 72193 74170 74176 72193 72192 74160 72193 74177 74177
PROCEDURE contrast and without contrast pelvis without contrast (stone protocol) contrast contrast pelvis with contrast contrast contrast pelvis with contrast CT pelvis with CT abdomen with CT abdomen and CT pelvis with CT pelvis without CT abdomen and CT abdomen with CT pelvis with CT abdomen and • • • concern: of Area • • Below iliac crest Below unknown or Location apply both areas • Above iliac crest Above (hip bone) • (hip bone) • • inguinal) Adrenal mass Adrenal protocol) (stone Stone Abdominal pain Abscess umbilical, ventral, Hernia (ie, Mass Bone Infection, Illiac joints / mass / mets / tumor Cancer Cancer staging Cancer Cysts Hernia Infection Mass Pain arthritis Fracture, Any cancer staging cancer Any Appendicitis colitis / ulcerative Crohns Diarrhea Diverticulitis IBD COMMON REASON FOR EXAM COMMON • • • • • • • • • • • • • • • • • • • • • PART CT / CTA: General CT / CTA: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology BODY BODY See below for standard See for below standard See for below CT standard See for below See below for standard See for below See below for standard CT standard See for below See below for standard CT standard See for below Adrenal Preps: CT Preps. / Pelvis Abdomen Preps: CT Preps. / Pelvis Abdomen Preps: Preps. Oral Contrast Pelvis (bone) Pelvis Preps: CT Preps. Pelvis (soft tissue) Pelvis Preps: Preps. Oral Contrast Abdomen / Pelvis Abdomen Preps: Preps. Oral Contrast Nothing to eat two hours prior to exam. No oral contrast needed. Drink eat two plenty hours prior exam. No oral contrast needed. Nothing to CT to Standard Preps: scheduled appointment. appointment. Arrive to 30 mins before Bring cards insurance of water. Preps: prior exam, patient needs pick up oral contrast at least one day to CTAt Standard Contrast Oral instructions will be given. Further one of our locations. any
CT / CTA 15 CT / CTA www.radltd.com 16 CODE 74160 74170 74170 74170 74178 75635 74175 74174 PROCEDURE contrast without and with contrast (pancreatic time) 1st protocol without and with contrast (kidney protocol) and without contrast protocol) (liver Run off pelvis CT abdomen with CT abdomen CT abdomen CT abdomen with CT IVP or CT urogram abdomen and CTA CTA abdomen CTA abdomen and CTA • • • • • • • • (MR preferred) (MR preferred) kidney and/or bladder malfunction Pancreatic mass Pancreatic Pancreatitis Pseudocyst Any renal pathology renal Any Hepatoma, Hepatitis, Cirrhosis Hepatitis, Hepatoma, hemangioma Liver Transitional cell carcinoma of cell carcinoma Transitional Hematuria Claudication Artery Peripheral Disease (PAD) Mesenteric ischemia Renal artery stenosis AAA vessels Crossing obstruction Stent / / leak COMMON REASON FOR EXAM COMMON • • • • • • • • • • • • • • •
PART CT / CTA: General CT / CTA: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To BODY BODY See below for standard CT standard See for below See below for standard CT standard See for below See below for standard CT standard See for below See below for standard See for below See below for standard See for below See below for standard See for below standard CTstandard prep. Oral Contrast Preps. Oral Contrast for see below oral contrast needed, Diagnosis for renal calculi-no renal for Diagnosis Note: Preps: Preps: Kidneys Oral Contrast Preps. Oral Contrast Preps: Preps: Pancreas Oral Contrast Preps. Oral Contrast Preps: Preps: Liver
Preps: Preps: CT Preps. CT Urogram / CTCT IVP Urogram Preps: Preps: CT Preps. CTA Abdomen & Run Off Abdomen CTA CT Preps. Preps: Preps: Stent Renal Arteries Mesenteric Vessels Mesenteric Abdominal AortaAbdominal any one of our locations. Further instructions will be given. Further one of our locations. any Preps: prior exam, patient needs pick up oral contrast at least one day to CTAt Standard Contrast Oral of water. Bring insurance cards to appointment. Arrive 30 mins before scheduled appointment. scheduled appointment. appointment. Arrive to 30 mins before Bring insurance cards of water. Nothing to eat two hours prior to exam. No oral contrast needed. Drink eat two plenty hours prior exam. No oral contrast needed. Nothing to CT to Standard Preps: CODE 70480 70481 70498, 70496 70496 70498 70460 70450 PROCEDURE authorize with both) authorize contrast contrast CT orbit without contrast CT orbit with contrast CTA head / brain head CTA neck CTA neck (please head, CTA CT head / brain with CT / brain without head • • • • • • • COMMON REASON FOR EXAM COMMON Cellulitis Exophthalmos disease Graves’ Mass Pain Pseudotumor Foreign body Foreign Fracture Trauma AVM (Arteriovenous Malformation) AVM Bruit stenosis Carotid CVA Stroke TIA Vascular tumor Vertebrobasilar Vertebrobasilar Insufficiency Aneurysm (Arteriovenous Malformation) AVM Bruit CVA Stroke TIA Vascular tumor Headache more than 7 days Headache more HIV Infection Mass / tumor Meningioma Meningitis Metastatic staging Seizures Toxoplasmosis Vertigo / dizziness / mastoiditis Alzheimer’s CVA Headache less than 7 days Hydrocephalus Memory confusion loss, Shunt check Stroke / bleed Trauma • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • CT / CTA: Head and Spine Head CT / CTA: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology PART BODY BODY See below for standard See for below See below for standard See for below See below for standardSee for below See below for standardSee for below See below for standardSee for below See below for standardSee for below Orbit Preps: CT contrast preps. Orbit Preps: CT preps. CTA Neck, Carotid Artery Neck, Carotid CTA Preps: CT contrast preps. CTA Brain CTA Preps: CT contrast preps. Head / Brain Preps: CT contrast preps. Head / Brain Preps: CT preps. prior to exam. No oral contrast needed. Drink eat two plenty hours prior exam. No oral contrast needed. Nothing to CT to Standard Preps: scheduled appointment. appointment. Arrive to 30 mins before Bring insurance cards of water. Bring eat two hours prior exam. DrinkNothing to to plenty Preps: of water. CTStandard Contrast exam. appointment. Arrive to 30 mins before insurance cards
CT / CTA 17 CT / CTA www.radltd.com 18 CODE 70470 70480 72132 72131 72129 72126 72128 72125 70487 70486
PROCEDURE with contrast bones without contrast contrast without contrast contrast without contrast contrast without contrast contrast CT brain without and CT temporal inner ears, CT lumbar spine with CT lumbar spine CT thoracic spine with CT thoracic spine CT cervical spine with CT cervical spine CT sinus with contrast CT sinus without • • • • • • • • • • herniation, mets, infection herniation, mets, herniation, mets, infection herniation, mets, changes herniation, mets, infection herniation, mets, surgery COMMON REASON FOR EXAM COMMON Trauma, fracture, fusion, pars defect fracture, Trauma, MRI unless contraindicated Cholesteotoma Trauma Abscess or infection MR Recommended for disc MR Recommended for MR recommended for disc for MR recommended degenerative bony Assess Abscess or infection Abscess or infection MR recommended for disc for MR recommended fusion fracture, Trauma, Mass or infection Functional endoscopic sinus Functional Ostiomeatal complex Sinusitis • • • • • • • • • • • • • • • • CT / CTA: Head and Spine Head CT / CTA: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology PART (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To BODY BODY See for below See for below See for below See for below See for below See for below See for below See for below See for below See for below Preps: Preps: CTstandard contrast preps. Pituitary Preps: Preps: CTstandard preps. Temporal Bone / IAC’s Temporal Preps: Preps: CTstandard contrast preps. Spine: Lumbar / SacralSpine: Lumbar Preps: Preps: CTstandard preps. Spine: Lumbar / Sacral Spine: Lumbar Preps: Preps: CTstandard preps. Preps: CTstandard contrast preps. Spine: Thoracic Spine: Thoracic Preps: Preps: CTstandard contrast preps. Spine: Cervical Preps: Preps: CTstandard preps. Spine: Cervical Preps: Preps: CTstandard contrast preps. Sinus / Face standard CTstandard preps. Preps: Preps: Sinus / Face insurance cards to appointment. Arrive 30 mins before exam. appointment. Arrive to 30 mins before insurance cards Nothing to eat two hours prior to exam. Drink plenty of water. Bring eat two hours prior exam. DrinkNothing to to plenty Preps: of water. CTStandard Contrast of water. Bring insurance cards to appointment. Arrive 30 mins before scheduled appointment. appointment. Arrive to 30 mins before Bring insurance cards of water. Nothing to eat two hours prior to exam. No oral contrast needed. Drink eat two plenty hours prior exam. No oral contrast needed. Nothing to CT to Standard Preps:
CODE
73700 73200 73201 73701 73206 73706
PROCEDURE upper extremity (mention part) extremitylower (mention part) concern) MRI preferred Note: Right indicate or Left (MR Preferred, of concern) and area MRI preferred Note: CT with contrast - upper CT with contrast - lower CT without contrast CT without contrast CTA upper extremity CTA extremity lower CTA • • • • (indicate Right or Left and area of Right and area (indicate or Left • •
for Lung Cancer Lung for
CT Screening Chest early, when it is easier to treat. when it is easier to early, of the CT screening lung cancer program is to detect is to lung cancer program Early detection matters. The goal The Early detection matters. mets / infection for tumor evaluations tumor for mass when evaluating for or infection without contrast except without contrast except All bone exams ordered All bone exams ordered Tumor / mass / cancer / Tumor
Peripheral artery Peripheral disease All bone exams ordered ordered All bone exams COMMON REASON FOR EXAM COMMON • • • •
PART CT / CTA: Musculoskeletal CT / CTA: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To
BODY BODY See for below See for below See below for standardSee for below See below for standardSee for below –Arm –Forearm –Wrist –Hand –Finger –Hip –Thigh –Knee –Calf –Ankle/Foot Extremities Preps: CTstandard contrast preps. Preps: Preps: CT preps. Lower Extremity Lower (lower extremity) (lower Arterial Stenosis extremity) (lower Preps: CTstandard contrast preps. Preps: Preps: CT preps. Upper Extremity Ischemia Nothing to eat two hours prior to exam. No oral contrast needed. Drink eat two plenty hours prior exam. No oral contrast needed. Nothing to CT to Standard Preps: scheduled appointment. appointment. Arrive to 30 mins before Bring insurance cards of water. Bring eat two hours prior exam. DrinkNothing to to plenty Preps: of water. CTStandard Contrast exam. appointment. Arrive to 30 mins before insurance cards
CT / CTA 19 CT / CTA www.radltd.com 20
CODE 71250 G0297 (medicare) Screening Diagnostic 74261 75574 75571 72192 51600 74177 74263 74175
PROCEDURE must meet criteria lung cancer screening without and with contrast without contrast with 3D rendering (virtual colonoscopy) arteriesrenal CT chest, low-dose, CTA coronary artery CTA CT calcium score CT cystogram CT enterography CT colonography abdomen for CTA • • • • (please authorize codes) BOTH • • • –Abscess –Bleeding sources obstruction–Bowel –Fistula –Inflammation –Tumor who are not candidates for not candidates who are colonoscopy routine Lung cancer screening Lung Abnormal echo Chest pain, sub tachycardia Screening, hyperlipidemia Screening, Bladder cancer Bladder polyps Bleeding Hydronephrosis reflux Vesicoureteral Crohn’s disease Crohn’s issues related Small bowel Screening Hypertension Renal artery stenosis Failed colonoscopy Failed taking blood thinners Patients COMMON REASON FOR EXAM COMMON • • • • • • • • • • • • • • • • PART CT / CTA: Specialty CT / CTA: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To BODY BODY Must have aMust have See below for standard See for below See below for standard See for below See below for standard See for below See below for standard See for below CT Preps. Preps: Preps: Screening CT Cancer Lung Chest time of scheduling. Arrival time provided at theArrival time provided caffeine the day of the exam. the day caffeine hours before exam. No hours before four home. Nothing to eat or drink Nothing to home. Preps: Preps: drive driver to responsible CTA Heart CTA Preps: Preps: CT Preps. CT Heart Preps: Preps: CT Preps. Urinary Bladder effect. Drinkeffect. plenty of water. exam may cause a laxativeexam may the remainder of the day. This of the day. the remainder after completion of exam for needs to stay near a restroom near a restroom stay needs to hours prior to arrival. Patient hours prior arrival. Patient to office. Nothing to eattwo Nothing office. exam for oral prep given in given oral prep exam for Arrive 90 mins before Preps: Small Intestine (bowel) Small Intestine CT Preps. Instructions will be given. Preps: Camp Lowell location. Further location. Lowell Camp Artery)(or Mesenteric to pick up bowel prep at our prep pick up bowel to Renal Artery prior exam, patient needs to daysthree least At Preps: Colon of water. Bring insurance cards to appointment. Arrive 30 mins before scheduled appointment. appointment. Arrive to 30 mins before Bring insurance cards of water. Nothing to eat two hours prior to exam. No oral contrast needed. Drink eat two plenty hours prior exam. No oral contrast needed. Nothing to CT to Standard Preps: 20
Screening: CT Cancer Lung for Required Information Additional CT / CTA: Specialty CT / CTA: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To For Medicare patients, the following G code should be G code the following patients, Medicare For used by provider for the shared decision-making the shared visit: for provider used by G0296 - Counseling visit to discuss need for lung cancer lung cancer discuss need for visit to G0296 - Counseling (LDCT)screening using low-dose CT scan (service is for decision-making) and shared eligibility determination do not that claims G0296 and G0297 for will deny Medicare ICD-10contain Z87.891, personal history use/ of tobacco personal history dependence of nicotine *Pack year calculator: http://www.shouldiscreen.com/pack-year-calculator/ calculator: year *Pack Smokers age 55-80 who have smoked 30 pack years who have Smokers age 55-80 ago and less than 15 years smokers 55-80 who quit Former also years smoked 30 pack Years* = Pack smoked Years x (20 cigarettes/pack) Packs/day • • • •
CT / CTA 21 DEXA www.radltd.com 22 CODE 77086 76499 77080 - hips, 77080 - hips, spine (axial skeleton) 77085
PROCEDURE DEXA (VFA) DEXA (BCS) DEXA DEXA DEXA + VFA #StartAt40 behind its recommendation Radiology Ltd. stands firmly Radiology Ltd. from breast cancer screening. screening. cancer breast from that women should receive yearly yearly should receive women that mammograms startingmammograms age 40 in at order to receive the maximum benefit receive to order
No vitamins, calcium or mineral supplements the day of the exam. calcium or mineral supplements the day No vitamins,
DEXA: Bone DensitometryDEXA: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology CLINICAL INDICATIONS (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To
DEXA Body Composition Study Body Composition DEXA
DEXA with Vertebral Fracture Assessment Fracture Vertebral with DEXA Assessment Fracture Vertebral Monitoring of Osteoporosis Monitoring Follow-Up Treatment for Prevention / Prevention for Treatment Follow-Up Vertebral Abnormalities Vertebral Long-Term Current Use of Steroid Treatment of Steroid Use Current Long-Term Long-Term Current Use of Other Use Medication Current Long-Term Early Surgical Menopause Early Surgical Post Menopause Post
preps. DEXA standard for See below Preps: preps. DEXA standard for See below Preps:
preps. DEXA standard for See below Preps: preps. DEXA standard for See below Preps:
order to appointment. to order clothing with metal. Arrive along with doctors 30 mins prior exam. Bringclothing with metal. to insurance cards Preps: DEXA Standard Avoid prior study. to given No IV or oral contrast permitted. medications are Prescribed 21 BRAIN W/O CONTRAST 70551 - 70552 - W/CONTRAST 70553 - W/O & W/CONTRAST CERVICAL SPINE W/O CONTRAST 72141 - 72142 - W/CONTRAST 72156 - W/O & W/CONTRAST CHEST W/O CONTRAST 71550 - 71551 - W/CONTRAST 71552 - W/O & W/CONTRAST BREAST 77049 - W/O & W/CONTRAST SPINE THORACIC W/O CONTRAST 72146 - 72147 - W/CONTRAST 72157 - W/O & W/CONTRAST ABDOMEN W/O CONTRAST 74181 - 74182 - W/CONTRAST 74183 - W/O & W/CONTRAST SPINE LUMBAR W/O CONTRAST 72148 - 72149 - W/CONTRAST 72158 - W/O & W/CONTRAST PELVIS W/O CONTRAST 72195 - 72196 - W/CONTRAST 72197 - W/O & W/CONTRAST CPT CODES for MRI SCANS MRI for CODES CPT all radiology for standards does imply protocol This not only. reference is for This change. Information is subject to facilities. (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To THIGH, LOWER LEG OR FOOT THIGH, LOWER NON-JOINT) EXTREMITY, (LOWER W/O CONTRAST 73718 - 73719 - W/CONTRAST 73720 - W/O & W/CONTRAST HIP, KNEE OR ANKLE HIP, JOINT) EXTREMITY, (LOWER W/O CONTRAST 73721 - 73722 - W/CONTRAST 73723 - W/O & W/CONTRAST HUMERUS, FOREARM OR NON-JOINT HUMERUS, NON-JOINT) (UPPER EXTREMITY, W/O CONTRAST 73218 - 73219 - W/CONTRAST 73220 - W/O & W/CONTRAST SHOULDER, ELBOW OR WRIST OR SHOULDER, ELBOW JOINT) (UPPER EXTREMITY, W/O CONTRAST 73221 - 73222 - W/CONTRAST 73223 - W/O & W/CONTRAST TMJ 70336 ORBIT, FACE & NECK & FACE ORBIT, W/O CONTRAST 70540 - 70542 - W/CONTRAST 70543 - W/O & W/CONTRAST
MRI / MRA 23 MRI / MRA www.radltd.com 24
CODE 70553 70553 70553 70551, 76377 70548 76390 70544 70553, 70553 70543 70336 70548 70544 70551 70553 70544
PROCEDURE with contrast (if patient has not MRI brain, please addhad recent MRI brain without & with contrast) codes) BOTH (please authorize contrast contrast to include NeuroQuant to analysis) (3D volumetric contrast MRA neck with contrast MRV without contrast MRI brain and orbits without and MRI brain without and with MRI brain without and with MRI brain without contrast MRI brain without MRA head without contrast MRA brain without contrast MRA neck with contrast MRI brain without and
MRI TMJ without contrast MRI MRI brain without and with contrast MRI brain without and with MRI Brain without contrast
MRI brain without and with
• • with contrast cranial nerves Att: • • • • • • • Please authorize BOTH codes. BOTH authorize Please •
• • pituitary Att: • •
Tumor / mass / cancer / mets, / mass / Tumor and all other lesions, Vascular reasons hydrocephalus, memory loss, hydrocephalus, mental status changes mental status Exophthalmos, proptosis Exophthalmos, disease Graves’ Headache, Pseudotumor, Seizures, Pseudotumor, Headache, Alzheimer’s, confusion, dementia, confusion, Alzheimer’s, Dissection stenosis Carotid Stroke / CVA Bruit Dissection stenosis Carotid Venous thrombosis Venous Vertebrobasilar insufficiencyVertebrobasilar TIA Bell’s palsy Bell’s Trigeminal neuralgia
Internal derangement Joint dysfunction Hearing loss
Dementia Memory loss Seizures
Elevated prolactin Elevated
COMMON REASON FOR EXAM COMMON • • • • • • • • • Mass / tumor • Metabolic abnormality disease • Demyelinating • • • • • • Stroke / CVA • TIA • Vertebrobasilar insufficiency • Bruit • • • • • • • • • MRI / MRA:MRI Brain standards doesnot imply protocol This only. reference is for This change. is subject Information to facilities. for all radiology
See for below See for below See for below See for below See for below See for below See for below BODY PART BODY See below for standardSee for below See below for standardSee for below See below for standardSee for below See below for standardSee for below See below for standardSee for below See below for standardSee for below
Brain Brain Neck Arch & Great Vessels Vessels & Great Arch standard MRI Brain Preps. standard Cranial Nerve SeriesCranial Preps: Preps: Preps: MRI Brain Preps. standard MRV – Brain Brain / Orbits / Face Brain Preps: Preps: Preps. MRI Brain Contrast MRI Brain Contrast Preps. MRI Brain Contrast Preps: Preps: Preps: Preps: Preps. MRI Brain Contrast Preps: Preps: MRI Brain Contrast Preps. MRI Brain Contrast Preps: Preps: Preps. MRI Brain Contrast Preps: Preps: Preps. MRI Brain Contrast standard MRI Brain Preps. standard Brain Preps: standard MRI Brain Preps. standard MRA Brain and Neck MRA Brain Vessels & Great –Arch Preps: Brain NeuroQuant Brain TMJ standard MRI Brain Preps. standard Preps: MRI Brain Preps. standard Pituitary Preps: MRA – Brain Preps: Preps: – MRI Brain Preps. standard Ear (IAC) Brain Ear (IAC) MRA – Depending or metal. jewelry, hairspray, makeup, wearing facial or eye eat two hours prior exam. Avoid Nothing to to Preps: Contrast MRI Brain Standard appointment. to exam. Bring insurance card Arrive 30 mins before or scrubs. gown be asked change into on the exam, may to Avoid wearing facial or eye makeup, hairspray, jewelry, or metal. Depending on the exam, may be asked to change into gown or gown Depending be asked change into on the exam, may or metal. to jewelry, hairspray, makeup, facial or eye wearing Avoid Preps: MRI Brain Standard appointment. to exam. Bring insurance card Arrive 30 mins before scrubs. 24 CODE 70543 72156 72146 72157 72141 PROCEDURE without and with contrast spine without contrast spine without and with contrast without contrast and with contrast MRI cervical spine MRI thoracic MRI thoracic MRI cervical spine MRI neck without
• • • • • COMMON REASON FOR EXAM COMMON AVM fx (with hx of malig / mets) Compression Discitis Multiple sclerosis Myelopathy Osteomyelitis Syrinx Back pain fx (with hx of malig / mets) Compression disease Degenerative Disc herniation Radiculopathy Discitis Multiple sclerosis Myelopathy Osteomyelitis Syrinx Arm / shoulder pain and/or weakness Chiari malformation disease Degenerative Disc herniation Neck pain fusion radiculopathy Post-op Vascular lesions Vascular planning (with hx of malig) Vertebroplasty Vertebroplasty planning (with hxVertebroplasty of no malig) Vascular lesions, AVM lesions, Vascular Tumor / mass / cancer / mets Tumor Trauma Tumor / mass / cancer / mets Tumor Infection Pain / mets / mass / cancer Tumor paralysis cord Vocal
• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • MRI / MRA:MRI Spine standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology
(520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To See for below See for below See for below See for below See for below BODY PART BODY Spine: Cervical standard MRI Contrast standard Preps. Neck (soft tissue) Preps: standard MRI Contrast standard Preps. Spine: Thoracic Preps: MRIstandard Preps. Spine: Thoracic Preps: Preps: Preps: MRI Contrast standard Preps. Preps: Preps: MRIstandard Preps. Spine: Cervical Nothing to eat two hours prior to exam. Avoid wearing facial or eye wearing facial or eye eat two prior hours exam. Avoid Nothing to to Preps: MRI Contrast a be asked Depending change into may on the exam, to or metal. jewelry, hairspray, makeup, appointment. to exam. Bring insurance card Arrive 30 mins before or scrubs. gown Depending on the exam, may be asked to change into gown or scrubs. gown be asked Depending change into on the exam, may to MRI Preps: Standard appointment. to exam. Bring insurance card Arrive 30 mins before
MRI / MRA 25 MRI / MRA www.radltd.com 26 CODE CODE 72148, 72195 72148 72195 72158 77049 77049 77049 77049 77049 (71552)
(please authorize PROCEDURE PROCEDURE MRI in addition to MRI in addition to protocol” “implant (and chest MRI, if necessary) Bilateral breast MRI breast Bilateral Bilateral breast breast Bilateral Bilateral breast MRI breast Bilateral Bilateral breast MRI breast Bilateral MRI breast Bilateral • • • • • to Includeto sacrum/SI joints codes) BOTH without contrast without and with contrast MRI lumbar spine MRI lumbar spine MRI lumbar spine
• • • COMMON REASON FOR EXAM COMMON chemotherapy indeterminate clinical or indeterminate (radiologist results imaging ) recommendation Follow-up for neo-adjuvant for Follow-up Suspected silicone implant leak lump Palpable Pain evaluation of Further Recent diagnosis of breast cancer of breast Recent diagnosis High cancer screening risk breast • • • • • • • COMMON REASON FOR EXAM COMMON
Back pain of no malig / mets) fx (with hx Compression disease Degenerative Disc herniation Radiculopathy Sacrum / SI joints Sciatica Spondylolisthesis Stenosis Compression fx (with hx of malig / mets) Compression Discitis Osteomyelitis Post-op When including sacurm/SI joints Vertebroplasty (with hx of malig) Vertebroplasty Trauma Tumor / mass / cancer / mets Tumor Vertebroplasty planning (with hxVertebroplasty of no malig)
• • • • • • • • • • • • • • • • • •
MRI: Breast standards does not imply protocol This only. is for reference This change. Information is subject to facilities. for all radiology MRI / MRA:MRI Spine standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology BODY PART BODY See below for standard See for below See below for standardSee for below See below for standardSee for below See below for standardSee for below See below for standardSee for below See 32 pg. See pg. 32 forSee pg. See pg. 32 for 32 See pg.
Please note: Breast MRI does not replace screening mammography. screening MRI does not replace Breast note: Please
BODY PART BODY
MRI Breast Preps. MRI Breast Chemotherapy Chemotherapy Treatment Follow-up for Follow-up Preps: MRI Breast Preps. MRI Breast MRI Breast Preps. MRI Breast Preps: Preps: Preps: results) clinical or imaging implants) (silicone Breast (indeterminate Breast standard MRIstandard Preps. Preps: Preps: standard MRIstandard Preps. Preps: Preps: Spine: Lumbar Contrast Preps. Contrast for standard standard MRIfor Preps: Preps: Spine: Lumbar MRI Breast Preps. MRI Breast Preps: Preps: staging) Preps. MRI Breast Breast (pre-operativeBreast Preps: (high risk screening) Breast Sacrum / SI joints Drink plenty of fluids day before exam, nothing to eat to hours priorwearto exam. exam, nothing two Do not Drink plenty before of fluids day BREAST MRI Preps: Standard appointment. to exam. Bring insurance card Arrive 30 mins before makeup. metal or eye deodorant, jewelry, hairspray, 25 26 CODE 74183 74181 71552 71552 75557 & 75561 74185 74185 74183 abdomen without and with contrast –MRA –MRI abdomen PROCEDURE without and with contrast without contrast (MRCP) mediastinum without and with contrast (specify brachial plexus) and with contrast MRI abdomen MRI abdomen MRI heart MRI chest / MRI chest without MRA abdomen 2 exams: Order • • • • • • • AND (please authorize codes) BOTH
COMMON REASON FOR EXAM COMMON valve issues valve Kidney eval eval Liver eval Pancreas All other reasons Adrenal MRCP (biliary ducts) / pancreatic Congenital defect and heart defect Congenital Brachial plexus injury Nerve avulsion / mets / mass / cancer Tumor Past MI - other cardiac issues MI - other cardiac Past Tumor / mass / cancer / mets / mass Tumor Pre liver transplant liver Pre kidney transplant Pre Renal mass-evaluation / pre-op AAA (Abdominal Aortic AAA (Abdominal Aneurysm) Abdominal aorta dissection Mesenteric ischemia Renal artery stenosis • • • • • • • • • • • • • • • • • • • Radiology Ltd. Offers 3T MRI! Radiology Ltd. Pelvis and Abdomen, / MRA:MRI Chest, all radiology for standards doesnot imply protocol This only. reference is for This change. Information is subject to facilities.
BODY PART BODY (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To See below for standardSee for below See below for standardSee for below See below for standardSee for below studies. and research small joints, abdominal imaging, prostate, This technology provides clinical advantages for certain for like exams clinical advantages provides technology This This machine is centrally located at our Camp Lowell and La Cholla sites. Lowell Camp our at located machine is centrally This Abdomen Abdomen six hours eat Nothing to Preps: priorinterfere exam, fluid will to wearing with the exam. Avoid be askedWill to jewelry or metal. or scrubs. a gown change into exam. BringArrive 30 min before appointment. to insurance card MRI Contrast Preps. MRI Contrast Heart Preps: MRI Contrast Preps. MRI Contrast Brachial Plexus Brachial Preps: Chest MediastinumChest Preps: Preps. MRI Contrast Nothing to eat six hours Nothing to Preps: priorinterfere exam, fluid will to wearing with the exam. Avoid be askedWill to jewelry or metal. or scrubs. a gown change into exam. BringArrive 30 min before appointment. to insurance card Nothing to eat two hours prior to exam. Avoid wearing facial or eye makeup, facial or eye wearing eat two hours prior exam. Avoid Nothing to to Preps: MRI Contrast Standard Arrive 30 or scrubs. a gown Depending be asked change into on the exam, may or metal. to jewelry, hairspray, appointment. to exam. Bring insurance card mins before
MRI / MRA 27 MRI / MRA www.radltd.com 28 CODE 74183 & 72197 72197 72197 76377 72195 72195 74183 72197
PROCEDURE without and withwithout and contrast and with contrast multiparmetric reconstructions contrast (best on 3T scanner) MRI prostate MRI urogram MRI pelvis without MRI dynamic pelvis MRI prostate with MRI prostate MRI pelvis without MRI enterography MRI enterography • • • • • • • COMMON REASON FOR EXAM COMMON abnormalities Benign prostatic hyperplasia (BPH) hyperplasia prostatic Benign prostate Enlarged cancer of prostate Evaluation Infection (prostatitis) abscess Prostate Hematuria - congenital Urinary tract obstruction Abscess Fibroid Osteomyelitis embolization / post fibroid Pre Septic arthritis / mass / cancer / mets Tumor diverticulum Urethral Pelvic organ prolapse organ Pelvic floor dysfunction Pelvic Outlet obstruction Incontinence Adenomyosis Fracture tear Muscle / tendon Crohn’s disease Crohn’s Inflammatory disease bowel • • • • • • • • • • • • • • • • • • • • • • • MRI / MRA: Chest, Abdomen, and Pelvis and Abdomen, / MRA:MRI Chest, standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology PART (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To BODY BODY See below for standard See for below Nothing to eat four Nothing to See below for standard See for below
Preps: Preps: Preps. MRI Contrast Prostate card to appointment. to card before exam. Bring insurancebefore gown or scrubs. Arrive 30 mins or scrubs. gown be asked to change into abe asked change into to wearing jewelry or metal. Will wearing jewelry or metal. Preps: Preps: hours prior exam. Avoid to Urogram Preps: Preps: Preps. MRI Contrast appointment. Pelvis effect. Bring insurance card to Bringeffect. insurance card This exam may have a laxative have exam may This exam for remainder of the day. of the day. remainder exam for restroom after completion ofrestroom gown or scrubs. Stay near a Stay or scrubs. gown be asked to change into abe asked change into to wearing jewelry or metal. Will wearing jewelry or metal. prior to exam. Avoid six hours prior exam. Avoid to before exam. Nothing to eat exam. Nothing to before Arrive minutes 90 Preps: Enterography Nothing to eat two hours prior to exam. Avoid wearing facial or eye makeup, wearing facial or eye eat two hours prior Avoid exam. Nothing to to Preps: MRI Contrast Standard Arrive 30 or scrubs. a gown Depending be asked change into on the exam, may to or metal. jewelry, hairspray, appointment. to exam. Bring insurance card mins before 27 28 CODE 73220 73720 73218 73718 73221 73721 73223 73723
PROCEDURE –Upper extremity extremity –Lower (Indicate Right or of and area Left concern) (Indicate Right or of and area Left concern) –Upper extremity extremity –Lower (Indicate Right or of and area Left concern) –Upper extremity extremity –Lower –Upper extremity extremity –Lower (Indicate Right or of and area Left concern) and with contrast contrast without contrast without - joint without and with contrast MRI - joint without MRI - non joint MRI - non joint MRI lower extremity MRI lower
• • • • COMMON REASON FOR EXAM COMMON tear, meniscal tear tear, Articular cartilageinjury Osteochondritis (OCD) dissecans fracture / fracture Stress (AVN) necrosis Avascular tear / tendon Tendinosis fasciitis Plantar Muscle strain Joint pain (specify joint) ligament Internal derangement, labral tear, Fracture tear Muscle / tendon Fracture Stress Abscess Arthritis - please specify) (special protocol Bone tumor / mass / cancer / mets Cellulitis Fasciitis Myositis neuroma Morton’s Osteomyelitis Soft tissue tumor / mass / cancer / mets Ulcer Infection / mass / cancer / mets Tumor Inflammatory arthritis Myositis • • • • • • • • • • • • • • • • • • • • • • • • • • MRI: Musculoskeletal MRI: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To See for below See for below See below See below BODY PART BODY Shoulder Elbow Wrist Hip Knee Ankle Toe Preps: MRI Preps. standard Arm Hand Finger Leg Foot Preps: MRI Preps. standard Arm Hand Finger Leg Foot Preps: MRI standard for Preps. Contrast Shoulder Elbow Wrist Hip Knee Ankle Toe Preps: MRI standard for Preps. Contrast Nothing to eat two hours prior to exam. Avoid wearing facial or eye makeup, wearing facial or eye eat two hours prior Avoid exam. Nothing to to Preps: MRI Contrast Standard Arrive 30 or scrubs. a gown Depending be asked change into on the exam, may to or metal. jewelry, hairspray, appointment. to exam. Bring insurance card mins before Depending on the exam, may be asked to change into a gown or scrubs. Arrive 30 or scrubs. a gown Depending be asked change into on the exam, may to MRI Preps: Standard appointment. to exam. Bring insurance card mins before
MRI / MRA 29 MRI / MRA www.radltd.com 30
CODE 71552 73222 73722 77002 23350 & 73040 24220 & 73085 25246 & 73115 27093 & 73525 27370 & 73580 27648 & 73615 –Shoulder –Elbow –Wrist –Hip –Knee –Ankle extremity with contrast arthrogram PROCEDURE 1–Upper OR lower guided 2–Fluoro 3–Choose body part: (Indicate Right or Left and area of concern) - order with 3 codes: - order with contrast MRI joint with contrast MRI chest without and MRI chest without • • ligament Labral tear TFCC/tear scapholunate bodies Loose OCD meniscus evaluation Post-op Pain Mass COMMON REASON FOR EXAM COMMON • • • • • • • open MRI called Espree X-Large MRI. open X-Large MRI called Espree Radiology Ltd. offers a better choice in choice a better offers Radiology Ltd. helps eliminate anxiety and claustrophobia. helps eliminate
(including Arthrography) (including Musculoskeletal MRI: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology See for below See for below BODY PART BODY
The open design of the Magnetom Espree works well for larger patients and patients larger for well works Espree of the Magnetom open design The
–Shoulder –Elbow –Wrist –Hip –Knee –Ankle
Preps. Preps: MRI Contraststandard MRI Arthrography Preps. standard MRI Contraststandard Preps: Preps: in shoulder) Scapula (not included Nothing to eat two hours prior to exam. Avoid wearing facial or eye makeup, facial or eye wearing eat twohours prior exam. Avoid Nothing to to Preps: MRI Contrast Standard Arrive 30 or scrubs. a gown Depending be asked change into on the exam, may or metal. to jewelry, hairspray, appointment. to exam. Bring insurance card mins before 29
PET/CT Bone Scan w/Sodium Fluoride (78816) PET/CT Brain (78608) PET/CT Myocardium (78459) Please fax any additional notes to: Scheduling Checklist PET / CT: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology Re-staging History of Staging (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To q q q PET/CT Whole Body (78816)PET/CT Whole Body Myeloma,(Diagnosis: Melanoma, Carcinoma Cell Sarcoma & Merkel Cutaneous Lymphoma) to Mid-ThighPET/CT Skull Base diagnosis) (78815) (All other Order for exam requested: exam Order for MR PET Pathology Biopsy CT Diagnosis Clinical history / progress notes Copy of patients insurance card(s) demographics Patient Indicate if for:
Interventional Scheduling Department at (520) 545-1898 Please include the following with ALL PET/CT orders: with ALL include the following Please If prior imaging studies were not performed at Radiology Ltd., Ltd., not performed at Radiology If prior imaging studies were reports listed below: please include any additional
PET / CT 31 PET/CT www.radltd.com 32 CODE 78816 CODE 78608 78816 78815 78459
PET/CT Imaging call (520) 545-1906, opt. 3. call (520) 545-1906, opt. Our PET services are centrally Our PET centrally services are To schedule a PET exam, please schedule a PET exam, To site. Lowell our Camp at located
REQUESTED TEXTREQUESTED REQUESTED TEXT (cannot be done if patient is diabetic) (cannot Sarcoma, & Merkel Cell Carcinoma, Cutaneous Lymphoma) & Merkel Cutaneous Sarcoma, Carcinoma, Cell PET / CT myocardium PET / CT brain PET / CT skull (all other diagnoses) mid-thigh base to PET / CT Melanoma, Myeloma, whole body (diagnosis: • • • • (Sodium fluoride PET bone scans are not covered by Medicare.) covered not are (Sodium fluoride PET bone scans PET / CT bone scan with sodium fluoride
• PET / CT: Bone Scan PET / CT: standards does not imply protocol This only. is for reference This change. Information is subject to facilities. for all radiology PET / CT: General PET / CT: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To BODY PART BODY BODY PART BODY Thyroid Prostate Lung Breast Myocardium Brain Whole Body Whole Skull Base to Mid-Thigh Baseto Skull CODE 76705 76705 76700 76857 76856 76856 Trans Abdominal 76830 Trans Vaginal 76830
PROCEDURE ultrasound ultrasound complete (transabdominal -and transvaginal preferred) only RUQ Abdominal Abdominal Pelvic limited Pelvic Pelvic ultrasound Pelvic only Transvaginal Transabdominal Transabdominal • • • • • • COMMON INDICATIONS COMMON upper quadrant or epigastric region) or epigastricupper quadrant region) uterus or ovaries; ultrasound is notuterus intestinal the exam of choice for disorders) • Abdominal pain (specify right• Abdominal pain or left • Abnormal LFT’s • Cirrhosis • Hepatitis C • Hepatomegaly disease • Polycystic • Splenomegaly • Abnormal LFT’s • Cirrhosis • Hepatitis C • Examples of single organ • Endometriosis uterus / enlarged • Fibroids • IUD • Menstrual disorders • Ovarian cysts • PCOS to specifically pain (relating • Pelvic ULTRASOUND: General ULTRASOUND: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To TYPE OF EXAM TYPE : 32oz of water : 32oz + 1.5 hours before appointment, 1.5 hours before is imaging using is imaging Ultrasound Pelvis pictures of produce to sound waves (belly in the pelvis structures and organs It down). button evaluate is used to Radiology and ovaries. Ltd.’s the uterus perform is to protocol both preferred the Transabdominal and Transvaginal the most detailed scans as these will give Ifinformation. only one study is perferred, a order is to our recommendation Transvaginal that scan. Note transvaginal not performedscans are on virgins. imaging using is imaging Ultrasound RUQ pictures of the produce to sound waves structures within the right upper quadrant abdomen. It help evaluate is used to and gallbladder, right kidney, the liver, pancreas. Preps: Preps: drink Next 32oz 30 minutes, empty bladder. drinking one hour before Finish of water. Ifappointment. A full bladder is required. exam. Arrive delay 30 may bladder is not full, and exam. Bring card, insurance mins before orders. doctor’s Preps: Child of water 3-5: 8oz Ages of water 6-10: 16oz Ages 11 Ages fat meal the evening Eat a low Preps: eat or drink nothing to anything before, medications are after midnight. Prescribed exam. Arrive 30 mins before permitted. orders. and doctor’s Bring insurance card evening fat meal the Eat a low Preps: eat or drink nothing to anything before, medications are after midnight. Prescribed exam. Arrive 30 mins before permitted. orders. and doctor’s Bringcard insurance is imaging of the Abdomen Ultrasound pictures of produce to using sound waves (bellythe structures within the abdomen up). Itbutton the help evaluate is used to spleen pancreas, kidneys, gallbladder, liver, and aorta.
ULTRASOUND 33 ULTRASOUND www.radltd.com 34
CODE & 76857 76857 76770 76770 PROCEDURE residual is needed) residual ultrasound (this will assess kidneys/ bladder and post- residual) void Bladder ultrasound Renal ultrasound Renal with bladder • (Indicate if post-void • • southern Arizona. Locally owned and owned Locally offers nine imaging offers Radiology Ltd. operated, across patients to centers COMMON INDICATIONS COMMON Bladder mass / stone Hematuria Flank / back pain Flank Hematuria bladder Neurogenic kidneys Polycystic Renal cyst / mass Renal disease (CKD) UTI • • • • • • • • •
ULTRASOUND: General ULTRASOUND: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology
(520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To TYPE OF EXAM TYPE : 32oz of water : 32oz : 32oz of water : 32oz + + Ages 11 Ages doctor’s orders. doctor’s of water 6-10: 16oz Ages exam. Bring your insurance card, and insurance card, exam. Bring your of water 3-5: 8oz Ages delay exam. Arrive delay 30 mins before Preps: Child required. If may bladder is not full, required. appointment. A full bladder is Finish drinking before one hour Finish 30 minutes, drink 32 oz of water. drink of water. 32 oz 30 minutes, appointment, empty bladder. Next appointment, empty bladder. 1 1/2 hours before 1 1/2 hours before Preps: Ages 11 Ages the bladder. insurance card and doctor’s orders. and doctor’s insurance card of water 6-10: 16oz Ages Arrive 30 mins before exam. BringArrive 30 mins before water of 3-5: 8oz Ages bladder is not full, may delay exam. delay may bladder is not full, Preps: Child bladder. A full bladder is required. If bladder is required. A full bladder. drink 16oz of water. Do not empty drink of water. 16oz 1 hour before appointment, 1 hour before Preps of the kidneys jets. ureteral and sound waves to produce pictures produce to sound waves imaging uses imaging Renal Ultrasound
sound waves to produce pictures of produce to sound waves imaging uses imaging Bladder Ultrasound CODE 76870 76536 Specify exact location Specify exact location Specify exact location PROCEDURE Specify Left/Right Testicular ultrasound Testicular ultrasound Tissue Soft Thyroid Thyroid ultrasound Soft Tissue ultrasound Tissue Soft Soft Tissue ultrasound • • •
• • EXAM
COMMON REASON FOR REASON FOR COMMON Bump Cyst Lipoma Mass Lump Palpable Hernia’s Bump Cyst Lipoma Mass Lump Palpable Epididymitis Hydrocele Orchalgia / swelling Pain lump Palpable Torsion Varicocele • • • • • (Epigastric, Inguinal,(Epigastric, Ventral) • • • • • • • • • • • • • • Enlarged thyroid / fullness thyroid • Enlarged • Goiter • Hypo- / hyper-thyroid • Nodules • Thyroiditis PART ULTRASOUND: General/Soft Tissue ULTRASOUND: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To BODY BODY See below for standard See for below See below for standard See for below See below for standard See for below See below for standard See for below See below for standard See for below Scalp / Head or Neck Chest Back Preps: Ultrasound Preps. Testicles Preps: Ultrasound Preps. Abdominal Wall Abdominal Groin/ Wall Pelvic Preps: Ultrasound Preps. Arms /Legs Arms Preps: Ultrasound Preps. Thyroid Thyroid Preps: Ultrasound Preps. Depending on the exam, may be asked to change into gown or scrubs. or scrubs. gown Depending be asked change into on the exam, may to Preps: Ultrasound Standard appointment. to along with doctors exam. Bring order insurance card Arrive 30 mins before
ULTRASOUND 35 ULTRASOUND www.radltd.com 36
CODE 93976 Duplex scan limited TIPS 93978 93880 93971 unilat 93970 bilat 93975 Abdominal duplex 93976 76706
PROCEDURE AAA for Medicare AAA for Medicare screening Medicare Not screening doppler doppler doppler (specify andupper or lower right, or leftbilateral, with indication for each) doppler – – Renal artery duplex / Carotid duplex / Carotid duplex / Venous Abdominal duplex / Aorta duplex • • • • • Family hx of AAA Family old male who 65-75 year risk factors Additional • • • preventative physical exam physical preventative (IPPE) risks:the following Must be referred from initial from Must referred be least one of at must have Patient least 100 “at has smoked cigarettes” include coronary heart hyper-tension, disease, disease cerebrovascular – – Swelling / pain Swelling Abdominal bruit Renal artery stenosis HTN Uncontrolled
Amaurosis fugax Amaurosis Arterial vascular disease Ataxia HTN Hyperlipidemia Stenosis Stroke TIA thrombosis Deep vein Redness extremity Upper and lower Portal HTN thrombosis Portal venous transplant Liver TIPS AAA screening for Medicare for AAA screening AAA Abdominal bruit / pulsatile mass Aortic dissection COMMON REASON FOR EXAM COMMON • • • • • • • • • • • • • • • • • • • • • • PART ULTRASOUND: Vascular ULTRASOUND: standards does imply protocol This not only. reference is for This change. is subject Information to facilities. for all radiology (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To BODY BODY See below for standard See for below standard See for below See below for standard See for below See below for standard See for below Renal Artery eat or drink Nothing to 8-12Preps: appointment. No hours before takeyourYou may soda or coffee. medications with a sipprescribed Arrive 30 before as needed. of water exam. Ultrasound Preps. Ultrasound Preps. Preps: Preps: Preps: Carotid ArteryCarotid Doppler Venous Extremity Upper or Lower extremity lumps and *For Tissue see Softbumps, Ultrasound* Duplex Abdominal fat meal the Eat a low Preps: Do not eat or drink before. evening may You after midnight. anything take medications prescribed your as needed. with a sip of water Ultrasound Preps. Preps: Preps: Aorta (Screening) Ultrasound Preps. Preps: Preps: Aorta and Iliacs Arrive 30 mins before exam. Bring insurance card along with doctors order to appointment. to along with doctors exam. Bring order insurance card Arrive 30 mins before Depending on the exam, may be asked to change into gown or scrubs. or scrubs. gown Depending be asked change into on the exam, may to Preps: Ultrasound Standard CODE 76882 76882 76882 76882 76882 76882 PROCEDURE Ankle ultrasound ultrasound Foot Hand/wrist ultrasound Knee ultrasound Shoulder Ultrasound ultrasound Elbow • Specify Left/Right/ Bilateral • Specify Left/Right/ Bilateral • Specify Left/Right/ Bilateral • Specify Left/Right/ Bilateral • Specify Left/Right/ Bilateral • Specify Left/Right/ Bilateral UPPER JOINT LOWER JOINTS LOWER COMMON REASON FOR EXAM COMMON posterior tibialis, peroneals) posterior tibialis, or tear Neuropathy Arthritis Arthritis Tendinosis Tendinosis Arthritis Rotator cuff tear cuff Rotator Arthritis Bicep Tendon Tendinosis/Tear Arthritis / Tendinosis Achilles tendinosis or tear tendinosis Achilles (anterior tibialis, Tendinosis Ganglion cyst abnormality Palpable body Foreign fasciitis Plantar neuroma Morton’s tear plate Plantar body Ganglion cyst/ Foreign abnormality Palpable Palpable abnormality Palpable Ganglion cyst body Foreign Rheumatoid arthritis / arthritis Median/ulnar/radial Neuropathy Baker cyst abnormality Palpable Tendinosis Quadriceps / patellar Ganglion cyst body Foreign Ganglion cyst body Foreign Biceps / triceps tear tendon Olecranon bursitis abnormality Palpable Ulnar / median / radial Ganglion cyst body Foreign • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • ULTRASOUND: Musculoskeletal (MSK) Musculoskeletal ULTRASOUND: standards doesnot imply protocol This only. reference is for This change. is subject Information to facilities. for all radiology PART BODY BODY See for below See for below See for below See for below See for below See for below Foot Ankle Elbow Hands /Wrists Preps: Preps: Ultrasound Preps. standard Preps: Preps: Ultrasound Preps. standard Preps: Preps: Ultrasound Preps. standard Preps: Preps: Ultrasound Preps. standard Knee Preps: Preps: Ultrasound Preps. standard Shoulder Shoulder Preps: Ultrasound Preps. standard Depending on the exam, may be asked to change into gown or scrubs. or scrubs. gown Depending be asked change into on the exam, may to Preps: Ultrasound Standard appointment. to along with doctors exam. Bring order insurance card Arrive 30 mins before
ULTRASOUND 37 X-RAY www.radltd.com 38 CPT CODE 71045 71046 71047 71048 71100 71101 71110 71120 71130 74018 74019 74021 74022 72170 72190 72220 72202 73140 73120 73130 73100 73110 73090 73092 73070 73080 73060 73020 PROCEDURE DESCRIPTION PROCEDURE X-rays can be scheduled or done on a walk-in basis. be scheduled or done on a walk-in can X-rays X-RAY: General X-RAY: does This only. reference for are codes CPT X-ray The basis. on a walk-in done are X-rays change. is subject Information to facilities. for all radiology standards protocol not imply Chest Chest 1 View Chest Chest 2 Views Chest Chest 3 Views Chest 4 or More Views 4 or More Chest Ribs Unilateral 2 Views 2 Ribs Unilateral Ribs Unilateral 2 Views with PA CXR with PA Views 2 Ribs Unilateral Ribs Bilateral 3 Views 3 Ribs Bilateral Sternum Minimum 2 Views Minimum 2 Sternum Sternoclavicular Joints 3 Views 3 Joints Sternoclavicular Abdomen Abdomen 1 View Abdomen Abdomen 2 Views Abdomen 3 or More Views 3 or More Abdomen Acute Abdomen Series + PA CXR 3 Views CXR 3 Series Abdomen + PA Acute Pelvis 1 or 2 Views 1 or 2 Pelvis Pelvis Minimum 3 Views Minimum 3 Pelvis Sacrum & Coccyx Minimum 2 Views MinimumSacrum 2 & Coccyx Sacroiliac Joints 3+ Views 3+ Joints Sacroiliac Finger(s) Minimum 2 Views Minimum 2 Finger(s) Hand 2 Views Hand Minimum 3 Views Hand Minimum 3 Wrist Wrist 2 Views Wrist Minimum 3 Views Minimum 3 Wrist Forearm 2 Views Forearm Upper Extremity Infant (up to 364 days old) Minimum 2 Views old) Minimum 2 Upper Extremity 364 days Infant (up to Elbow Elbow 2 Views MinimumElbow Views 3 Views Humerus Minimum 2 Shoulder 1 View • • • • • • • • • • • • • • • • • • • • • • • • • • • • CPT CODE 73650 73600 73610 73590 73592 73560 73562 73564 73565 77072 77073 77075 70100 70110 70030 70140 70150 70160 70200 70210 70220 73030 73050 73000 73010 73660 73620 73630 PROCEDURE DESCRIPTION PROCEDURE X-rays can be scheduled or done on a walk-in basis. be scheduled or done on a walk-in can X-rays X-RAY: General X-RAY: does This only. reference for are codes CPT X-ray The basis. on a walk-in done are X-rays change. is subject Information to facilities. for all radiology standards protocol not imply Ankle 2 Views Views Ankle Minimum 3 Views 2 & Fibula Tibia Views old) 2+ Extremity 364 days Infant (up to Lower Views Knee 1 or 2 Knee 3 Views Views Knee 4 or More Both Knees AP Standing Studies Bone Age Studies Bone Length (Bone Survey) Osseous Complete Views Mandible < 4 Mandible 4 Views MRI) OrbitScreening (Pre Views Bones < 3 Facial Views Bones Minimum 3 Facial Views Nasal Bones Minimum 3 Views Orbits Minimum 4 Views < 3 Sinuses Paranasal Views 3 Minimum Sinuses Paranasal Calcaneus (Heel) Minimum 2 Views Minimum (Heel) 2 Calcaneus Shoulder Minimum 2 Views MinimumShoulder 2 Acromioclavicular Joints Bilateral Joints Acromioclavicular Complete Clavicle Scapula Complete Views Minimum 2 Toe(s) Foot 2 Views Views Minimum 3 Foot • • • • • • • • • • • • • • • • • • • • • • • • • • • •
X-RAY 39 X-RAY www.radltd.com 40 CPT CODE 70250 70260 70360 72040 72050 72052 72070 72072 72074 72100 72110 72114 72120 72080 72081 72082 72083 72084 73501 73502 73503 73521 73522 73523 73551 73552 PROCEDURE DESCRIPTION PROCEDURE X-rays can be scheduled or done on a walk-in basis. be scheduled or done on a walk-in can X-rays X-RAY: General X-RAY: does This only. reference for are codes CPT X-ray The basis. on a walk-in done are X-rays change. is subject Information to facilities. for all radiology standards protocol not imply SkullViews Minimum 4 Cervical Spine) (Not for Tissue Neck Soft Views C-Spine 2 or 3 Views C-Spine Minimum 4-5 Views 6 or More C-Spine Complete 2 Views T-Spine 3 Views T-Spine 4 Views T-Spine Views L/S Spine 2 or 3 Views L/S Spine Minimum 4 Views) (Minimum 6 Views with Bending L/S Spine Complete Views) 2-3 (Only Views L/S Spine Bending Views) Junction (Minimum 2 Thoracolumbar Cervical and Including Skull, and Lumbar, Thoracic Entire Spine, View 1 Evaluation); Scoliosis Spine If (eg, Sacral Performed Cervical and Including Skull, and Lumbar, Thoracic Entire Spine, Views 2 or 3 Evaluation); Scoliosis Spine If (eg, Sacral Performed Cervical and Including Skull, and Lumbar, Thoracic Entire Spine, Views 4 or 5 Evaluation); Scoliosis Spine If (eg, Sacral Performed Cervical and Including Skull, and Lumbar, Thoracic Entire Spine, Views Min. 6 Evaluation); Scoliosis Spine If (eg, Sacral Performed View 1 Performed; When with Pelvis Unilateral, Hip, Views 2 or 3 Performed; When with Pelvis Unilateral, Hip, Views Minimum Performed; 4 When with Pelvis Unilateral, Hip, Views 2 Performed; When with Pelvis Bilateral, Hips, Views 3-4 Performed; When with Pelvis Bilateral, Hips, Views Minimum Performed; 5 When with Pelvis Bilateral, Hips, Femur; 1 View Views Minimum 2 Femur; Skull < 4 Views < 4 Skull • • • • • • • • • • • • • • • • • • • • • • • • • • INTERVENTIONAL INTERVENTIONAL RADIOLOGY SERVICES This is for reference only. This does not imply protocol standards for all radiology facilities. Information is subject to change. at the hospital due to risk of complications.at the hospital due to risk biopsies may need toan outside pathologist. be performed Certain order to obtain a small piece of tissue so that it can be examined by A needle is placed in a desired location using imaging guidance in Percutaneous Biopsy Image-Guided diagnosis and/or to reduce discomfort. A thin needle or tube is placed into the chest to remove fluid for Thoracentesis movement for paralysis to assess diaphragmatic Videofluoroscopicevaluation is performed Sniff Test PrepsSee on Page 46. PrepsSee on Page 46. PrepsSee on Page 46. diagnosis and/or reduce discomfort. A thin needle or tube is placed into the abdomen to remove fluid for Paracentesis Interventional Service
Minimally InvasiveMinimally Procedures Diagnostic Fluoroscopy Fluoroscopy Ultrasound Ultrasound Ultrasound Ultrasound Modality CT, CT CT or or or 32555 49083 32555 49083 76000 49180, 77002 Abdominal/Retroperitoneal Mass: 50200, 77002 Renal: Liver: 47000, 77002 Lung/Mediastinum: 32405, 77002 49180, 76942 Abdominal/Retroperitoneal Mass: 50200, 76942 Renal: Liver: 47000, 76942 Lung/Mediastinum: 32405, 76942 49180, 77012 Abdominal/Retroperitoneal Mass: Renal: Liver: Lung/Mediastinum: Thyroid: 47000, 77012 50200, 77012 10005 CPT Code(s) 32405, 77012 Interventional Interventional Interventional Interventional Interventional Performed Performed Radiologist, Radiologist, Radiologist, Radiologist Radiologist Radiologist RPA or NP RPA or NP or Body or Body or Body or Body or Body or RPA By Evaluation Required Yes No No No Required Hold Blood Hold Blood Hold Blood Coumadin. Coumadin. Coumadin. unless on unless on unless on Thinners Thinners specifics No labs No labs No labs call for Labs Yes, No Required Sedation Yes No No No No
4241 To schedule an interventional procedure, please call (520) 545-1906 or fax (520) 545-1898. INTERVENTIONAL RADIOLOGY SERVICES INTERVENTIONAL This is for reference only. This does not imply protocol standards for all radiology facilities. Information is subject to change. See PrepsSee on Page 46. or CT. most cases additional images are then obtained using MRI In and images are is injected symptomatic obtained. joint. Dye ankle) Arthrogram (shoulder, elbow, wrist, hip, knee, and See PrepsSee on Page 46. obtained using CT. images are most cases additional images are obtained. then In place a thin needle into and the spinal canal. is injected Dye Myelogram (thoracic, lumbar) See PrepsSee on Page 46. pressure on the joint. is removed for diagnostic analysis or to help relieve pain and fluid aspiration) A needle is placed into a joint space and fluid fluid aspiration, joint tap,Arthrocentesis (joint synovial Fluoroscopy is used to place a thin needle into the Interventional Service Fluoroscopy is used to Fluoroscopy; Fluoroscopy; Fluoroscopy Modality then MRI then CT CT CT Minimally InvasiveMinimally Procedures Diagnostic or or www.radltd.com Ankle: Ankle: Knee: Hip: Lower Joints Wrist: 73222, 25246, 73115, 77002 Elbow: Shoulder: Upper Joints Replace code 73722 with 73701 Replace Lower Joints code 73222 with 73201 Replace Upper Joints Use 62305 for 2 or 3 levels L-Spine: T-Spine: knee, subacromial bursa): 20610, 77002 knee, JointMajor or Bursa (shoulder, hip, olecranon bursa): 20605, 77002 acromioclavicular, elbow, wrist, ankle, Intermediate Joint or Bursa (TMJ, 20600, 77002 Small Joint or Bursa knee, subacromial bursa): 20610, 77012 knee, JointMajor or Bursa (shoulder, hip, olecranon bursa): 20605, 77012 acromioclavicular, elbow, wrist, ankle, Intermediate Joint or Bursa (TMJ, 20600, 77012 Small Joint or Bursa (fingers, toes): 73722, 27093, 73525, 77002, 27095 73722, 27369, 73580, 77002 73722, 27648, 73615, 77002 73222, 24220, 73085, 77002 62304, 72132 62303, 72129 73222, 23350, 73040, 77002 CPT Code(s) (fingers, toes): Performed By Neuroradiologist Musculoskeletal Interventional, Interventional Radiologist, Radiologist, Body, or Body RPA RPA or Evaluation Required No No No Required Hold Blood Hold Blood Coumadin. Coumadin. unless on unless on No labs No labs Labs No No Required Sedation No No No
To schedule an interventional procedure, please call (520) 545-1906 or fax (520) 545-1898. 4243 INTERVENTIONAL INTERVENTIONAL RADIOLOGY SERVICES This is for reference only. This does not imply protocol standards for all radiology facilities. Information is subject to change. See PrepsSee on Page 46. prevents cerebrospinal and allows the dural hole to heal. fluid (CSF) leakage encountered dural puncture. after as a gelatinous glue which The blood patch acts Epidural Blood Patch (EBP) is used to treat spinal headaches that are most commonly Epidural Blood Patch PrepsSee on Page 46. fracture. intocement and contrast is then injected the sacrum through the needles to stabilize the Sacroplasty PrepsSee on Page 46. to cement is then injected stabilize Bone the fracture.into a fractured vertebra. Kyphoplasty (thoracic, guidance is used to lumbar) Fluoroscopy place a needle or CT PrepsSee on Page 46. to cement is then injected stabilize Bone the fracture.into a fractured vertebra. Vertebroplasty (thoracic, guidance is used to lumbar) Fluoroscopy place a needle or CT
CT is used to guide two needles into a fractured sacrum. A mixture of bone is used to needles into of bone guide two a fractured sacrum. A mixture CT Interventional Service
Fluoroscopy Fluoroscopy Modality CT CT Pain Management or 62273, 77003 on separate vertebrae, use 20225) use 22515 (if biopsy is performed L-Spine: level 22514, each add’l on separate vertebrae, use 20225) use 22515 (if biopsy is performed T-Spine: level 22513, each add’l 22511 on separate vertebrae, use 20225) use 22512 (if biopsy is performed L-Spine: level 22511, each add’l on separate vertebrae, use 20225) use 22512 (if biopsy is performed T-Spine: level 22510, each add’l CPT Code(s) Performed By Neuroradiologist Interventional Interventional Radiologist Radiologist Scan within 30 within 30 Scan Scan within 30 within 30 Scan (520) 545-1906 scheduling for scheduling for interventional interventional Evaluation either MRI or either MRI or either MRI or either MRI or consult with consult with consult with consult with Yes, requires Yes, requires Neurologist. Neurologist. Sometimes, Sometimes, Required Radiologist Radiologist Radiologist Radiologist CT + Bone + Bone CT CT + Bone + Bone CT Must have Must Must have Must more info. contact contact days days and and and and Required Hold Blood Hold Blood Coumadin. Coumadin. unless on unless on Thinners specifics specifics No labs No labs call for call for Labs Yes, Yes, Required Sedation Yes Yes No
4443 To schedule an interventional procedure, please call (520) 545-1906 or fax (520) 545-1898. INTERVENTIONAL INTERVENTIONAL RADIOLOGY SERVICES This is for reference only. This does not imply protocol standards for all radiology facilities. Information is subject to change. decrease pain and swelling. Steroid intoJoint medication is injected the symptomatic Injection joint to See PrepsSee on Page 46. PrepsSee on Page 46. PrepsSee on Page 46. root, facet and sacroiliac joint injections. nerve leg pain. These can be both diagnostic and therapeutic include epidural, and/or steroid medications are in the spine to injected reduce back and/or (epidural, root, nerve Spinal Injection facet, and sacroiliac) Anesthetics can then be removed for testing. into the spinal canal. Cerebrospinal and a needle is inserted back, fluid (CSF) rachiocentesis) Lumbar Puncture (spinal tap, spinal puncture, thecal puncture, Local into anesthesia is injected the lumbar region of the Interventional Service
www.radltd.com Fluoroscopy Fluoroscopy Fluoroscopy Modality CT CT or or Pain Management (2nd), 64495 (3rd) Lumbar Facet: 64493 (1st), 64494 L-Spine: 64483, 64484 (per level/per Root/Block side) Nerve SI: 62323 Epidural: L-Spine: 62323 62328 20611 Major: Intermediate: 20606 Small : 20604 Ultrasound: joint/bursa:Major 20610 Intermediate joint/bursa: 20605 Small joint/bursa: 20600 Fluoro guidance: 77002 Fluoroscopy : (2nd), 64495 (3rd) Lumbar Facet: 64493 (1st), 64494 L-Spine: 64483, 64484 (per level/per Root/Block side) Nerve Epidural: L-Spine: 62323 CPT Code(s) Performed By Neuroradiologist Practitioner Practitioner Radiology Radiology Assistant Assistant Evaluation Required either brain either brain Must have Must MRI or CT. MRI or CT. Yes No Required Hold Blood Hold Blood Hold Blood Coumadin. Coumadin. Coumadin. unless on unless on unless on Thinners Thinners is taking thinners No labs No labs No labs patient Only if Labs blood Required Sedation No No No
To schedule an interventional procedure, please call (520) 545-1906 or fax (520) 545-1898. 4445 INTERVENTIONAL INTERVENTIONAL RADIOLOGY SERVICES This is for reference only. This does not imply protocol standards for all radiology facilities. Information is subject to change. attached which enters the vein. on the upper chest area and has a plastic tube skin entirely under your which is inserted access device venous is a long term or mediport A chest port Chest Port Placement malfunction. to check for of dye into is injected the Chest port fluoroscopic Utilizing guidance a small amount Chest Port Dye Check have(Must Ltd.) been placed by Radiology Chest Port Removal See PrepsSee on Page 46. PrepsSee on Page 46. PrepsSee on Page 46. PrepsSee on Page 46. punctures. forthe necessity multiple needle IV therapylong term and eliminates upper chest. The catheter is used for vein and then into the in the arm used to guide a catheter through a Fluoroscopy and ultrasound are PICC Line Placement Interventional Service Modality Fluoroscopy Fluoroscopy Fluoroscopy Fluoroscopy Ultrasound Ultrasound Ultrasound Ultrasound & & & & 36598 36950, 77001 36561, 77001, 76937 36573 CPT Code(s) Vascular Services Interventional Radiologist Radiologist Interventional Radiologist Interventional or Radiology Practitioner or Radiology Practitioner or Radiology Radiology Practitioner Radiology Practitioner Radiology Performed By Assistant Assistant Assistant Assistant Evaluation Required No No No No Required Coumadin . Coumadin . Hold Blood Hold Blood Hold Blood unless on unless on unless on Thinners. Thinners. No labs No labs No labs Labs None None Required Sedation Yes Yes No No
4645 To schedule an interventional procedure, please call (520) 545-1906 or fax (520) 545-1898. INTERVENTIONAL ICD-9 CODESINTERVENTIONALICD-9 ICD-10 INTERVENTIONAL RADIOLOGY PREPS This is for reference only. This does not imply protocol standards for all radiology facilities. Information is subject to change.
Paracentesis Preps: Off Coumadin/Aspirin/Aggrenox/ Brilanta for 5 days (exam scheduled on 6th day) . Off Effient for 7 days (exam scheduled on 8th day). Off Pletal, Savaysa, Lovenox and Xaralto for 24 hours (restart the day after the exam). Off Eliquis for 48 hours. Off Pradaxa for 2 days with normal renal function, 5 days with abnormal renal function. Plavix does not need to be held. Obtain prescribing doctor’s approval to hold meds. STAT labs drawn the day before procedure if on Coumadin. Labs not required unless on Coumadin. PTT, PT/INR, CBC w/Platelets. Need instructions for fluid. Arrive 30 minutes early. Must have a responsible driver.
Thoracentesis Preps: Off Coumadin/Aspirin/Aggrenox/ Brilanta for 5 days (exam scheduled on 6th day) . Off Effient for 7 days (exam scheduled on 8th day). Off Pletal, Savaysa, Lovenox and Xaralto for 24 hours (restart the day after the exam). Off Eliquis for 48 hours. Off Pradaxa for 2 days with normal renal function, 5 days with abnormal renal function. Plavix does not need to be held. Obtain prescribing doctor’s approval to hold meds. STAT labs drawn the day before procedure if on Coumadin. If not on blood thinners w/in 30 and must be received two days prior to procedure. PTT, PT/INR, CBC w/Platelets. INR less than or equal to 2.0. Platelets greater than or equal to 25,000. Please send fluid instructions. Arrive 30 minutes early. Must have a responsible driver.
Image-Guided Percutaneous Biopsy Preps: No solid food 6 hours before exam. Clear liquids are permitted up until 2 hours before exam. Must have a responsible driver to drive you home. Arrive 60 mins before exam. Screen for all anticoagulants listed, and schedule appointment based on the recommended days off of medication. Send lab request for PTT, PT/INR, CBC w/platelets to ordering provider. Aggrenox/Aspirin 325mg/Brilinta/ Coumadin/Plavix off for 5 days, exam on 6th day. (Labs drawn day before exam if on Coumadin). Effient off for 7 days, exam on 8th day. Pradaxa off for 2 days with normal renal function, 5 days with abnormal renal function. Pletal, Lovenox, Savaysa and Xarelto hold for 24 hrs (restart 24 hrs after exam)**Obtain prescribing doctor’s approval to hold meds**
Arthrogram (shoulder, elbow, wrist, hip, knee, and ankle) Preps: No solid food or liquids 1 hour before exam. A driver is recommended but not required. Arrive 30 mins before exam. Labs are not required and patient can continue anticoagulants.
Myelogram (thoracic, lumbar) Preps: Aggrenox/Brilinta/Coumadin hold 5 days, exam on day 6. If patient is on Coumadin need STAT labs PT/PTT/INR within 24 hrs of exam. Aspirin is ok to continue. Effient and Plavix hold 7 days. Eliquis and Xarelto hold 2 days. Lovenox/Pletal/Savaysa hold 24 hrs. No solid food or liquids 1 hour before exam. A driver is required. Arrive 30 mins before exam. Screen for all anticoagulants listed, and schedule appointment based on the recommended days off of medication. www.radltd.com www.radltd.com Arthrocentesis (joint fluid aspiration, joint tap, synovial fluid aspiration) Preps: No solid food or liquids 1 hour before exam. A driver is recommended but not required. Arrive 30 mins before exam. Labs are not required and patient can continue anticoagulants. Please send fluid instructions.
Vertebroplasty (thoracic, lumbar) Preps: All appointments must have had a consult prior to exam. No solid food 6 hours before exam, but clear liquids are permitted up until 2 hours before exam. Must have a responsible driver to drive you home. Arrive 60 mins before exam. Screen for all anticoagulants listed, and schedule appointment based on the recommended days off of medication. Send lab request for PTT,PT/INR, CBC w/ platelets to ordering provider. INR greater than or equal to 1.5. Platelets greater than or equal to 50,000. Aggrenox/Brilinta/Coumadin hold 5 days, exam on day 6. If patient is on Coumadin need STAT labs PT/PTT/INR within 24 hrs of exam. Aspirin is ok to continue. Effient and Plavix hold 7 days. Eliquis and Xarelto hold 2 days. Lovenox/Pletal/Savaysa hold 24 hrs.
Kyphoplasty (thoracic, lumbar) Preps: All appointments must have had a consult prior to exam. No solid food 6 hours before exam, but clear liquids are permitted up until 2 hours before exam. Must have a responsible driver to drive you home. Arrive 60 mins before exam. Screen for all anticoagulants listed, and schedule appointment based on the recommended days off of medication. Send lab request for PTT,PT/INR, CBC w/ platelets to ordering provider. INR greater than or equal to 1.5. Platelets greater than or equal to 50,000. Aggrenox/Brilinta/Coumadin hold 5 days, exam on day 6. If patient is on Coumadin need STAT labs PT/PTT/INR within 24 hrs of exam. Aspirin is ok to continue. Effient and Plavix hold 7 days. Eliquis and Xarelto hold 2 days. Lovenox/Pletal/ Savaysa hold 24 hrs.
Sacroplasty Preps: All appointments must have had a consult prior to exam. No solid food 6 hours before exam, but clear liquids are permitted up until 2 hours before exam. Must have a responsible driver to drive you home. Arrive 60 mins before exam. Screen for all anticoagulants listed, and schedule appointment based on the recommended days off of medication. Send lab request for PTT,PT/INR, CBC w/ platelets to ordering provider. INR greater than or equal to 1.5. Platelets greater than or equal to 50,000. Aggrenox/Brilinta/Coumadin hold 5 days, exam on day 6. If patient is on Coumadin need STAT labs PT/PTT/INR within 24 hrs of exam. Aspirin is ok to continue. Effient and Plavix hold 7 days. Eliquis and Xarelto hold 2 days. Lovenox/Pletal/Savaysa hold 24 hrs.
Epidural Blood Patch Preps: No solid food or liquids 1 hour before exam. Must have a responsible driver. Arrive 30 mins before exam. Screen for all anticoagulants listed, and schedule appointment based on the recommended days off of medication. Aggrenox/Brilinta/Coumadin hold 5 days, exam on day 6. If patient is on Coumadin need STAT labs PT/PTT/INR within 24 hrs of exam. Aspirin is ok to continue. Effient and Plavix hold 7 days. Eliquis and Xarelto hold 2 days. Lovenox/Pletal/Savaysa hold 24 hrs.
Spinal Injection (epidural, nerve root, facet, and sacroiliac) Preps: Aggrenox/Brilinta/Coumadin hold 5 days, exam on day 6. If patient is on Coumadin need STAT labs PT/PTT/INR within 24 hrs of exam. Aspirin is ok to continue. Effient and Plavix hold 7 days. Eliquis and Xarelto hold 2 days. Lovenox/Pletal/ Savaysa hold 24 hrs. No solid food or liquids 1 hour before exam. Must have a responsible driver. Arrive 30 mins before exam. Screen for all anticoagulants listed, and schedule appointment based on the recommended days off of medication.
Joint Injection Preps: No solid food or liquids 1 hour before exam. A driver is recommended by not required. Arrive 30 mins before exam. Labs are not required and patient can continue anticoagulants.
Lumbar Puncture (spinal tap, spinal puncture, thecal puncture, rachiocentesis) Preps: Aggrenox/Brilinta/Coumadin hold 5 days, exam on day 6. If patient is on Coumadin need STAT labs PT/PTT/INR within 24 hrs of exam. Aspirin is ok to continue. Effient and Plavix hold 7 days. Eliquis and Xarelto hold 2 days. Lovenox/Pletal/Savaysa hold 24 hrs. No solid food or liquids 1 hour before exam. A driver is recommended but not required. Arrive 30 mins before exam. Screen for all anticoagulants listed, and schedule appointment based on the recommended days off of medication.
PICC Line Placement Preps: Must have a responsible driver to drive you home. Arrive 30 mins before exam. No labs required, and anticoagulants are ok.
Chest Port Placement/Removal Preps: NPOx 6 hrs. No labs unless on Coumadin, hold blood thinners. Must have a responsible driver.
To schedule an appointment, call (520) 733-7226 or fax (520) 290-8377. 4647 CODE common in your practice. in your common Please use the spaces below use the spaces Please for notes or additional codes for notes REQUESTED TEXTREQUESTED CODE ICD-10 CODES NOTES ICD-10 CODES (520) 290-8377. (520) 733-7226 or fax schedule an appointment, call To common in your practice. in your common Please use the spaces below use the spaces Please for notes or additional codes for notes REQUESTED TEXTREQUESTED
ICD-10 CODES 47 ICD-9 CODESINTERVENTIONALICD-9 ICD-10 ICD-10 CODES NOTES
REQUESTED TEXT CODE REQUESTED TEXT CODE Please use the spaces below Please use the spaces below for notes or additional codes for notes or additional codes common in your practice. common in your practice. www.radltd.com
To schedule an appointment, call (520) 733-7226 or fax (520) 290-8377. 4849 RADIOLOGY LTD. IS A PREFERRED PROVIDER FOR THE FOLLOWING INSURANCES
MAJOR INSURANCE PLANS MAJOR NETWORK PLANS • AARP Medicare Complete (Formally • Accountable Health Plans Secure Horizons) • Ancillary Care Services • Aetna US Healthcare (not contracted with Aetna Sr) • Arizona Foundation for Medical Care • AHCCCS (All Plans) • Beech Street • Banner Health Plus • CCN • Blue Cross/Blue Shield including • Coventry National BCBS Advantage • First Health (Individual Provider Contracts) • Care1st HealthPlan (AHCCCS) • Health Management Network • CareMore Health Plan • MultiPlan • Cenpatico • Cigna (excludes Health Springs HMO) • PHCS • Cochise Health System • Department of Labor • EverCare and Community Plan UHC* (Formally EverCare Select) • GEHA • Health Choice Arizona • Health Choice Generations • Health Net / Health Net Medicare Advantage • Health Net Allwell/Ambetter • Health Net Federal Services (Tricare) • Humana • Humana Community HMO • Humana Gold • Indian Health Services • Mail Handlers Benet Plan (MHBP) • Mayo Health Plan Arizona • MDIA (Medrisk Data)* • Medicare • Mercy Care Healthcare Group • Meritain • OneCare • One Call Care Diagnostic • Preferred Medical Claim Solutions • State Compensation Fund If you need further assistance • TriWest VA with insurances, please call our • UHC West (Formally Pacicare) Insurance Billing Representatives • United Medical Resources (UMR) at (520) 296-0278. • United Healthcare • United Healthcare Community Plan* (Formally APIPA) • United Healthcare Medicare Complete 49 • University Family Care (AHCCCS) • University Physician Advantage * Not contracted with Carondelet for CT, Ultrasound, X-ray WE HAVE 9 IMAGING CENTERS TO SERVE YOU
1 Camp Lowell Imaging Center 5 Rancho Vistoso Diagnostic Imaging 4640 E. Camp Lowell Dr. 2551 E. Vistoso Commerce Loop Tucson, AZ 85712 Oro Valley, AZ 85755 Tel: (520) 318-6144 Tel: (520) 825-1990
Radiology Ltd. - 2 La Cholla Center for Diagnostic 6 Imaging and Treatment Rincon Imaging Center 10350 E. Drexel Road Tucson, AZ 85747 5960 N. La Cholla Blvd. Tel: (520) 290-4846 Tucson, AZ 85741 Tel: (520) 797-3439 7 St. Joseph’s Imaging Center 330 N. Wilmot Rd. Tucson, AZ 85710 3 Midvale Imaging Center 1598A West Commerce Ct. Tel: (520) 290-4840 Tucson, AZ 85746 Tel: (520) 290-4842 8 Wilmot Center for Diagnostic Imaging and Treatment
4 Radiology Ltd. - 677 N. Wilmot Rd. Carondelet Imaging Center Tucson, AZ 85711 6567 E. Carondelet Dr., Suite 105 Tel: (520) 722-1832 Tucson, AZ 85710 Tel: (520) 751-3096
9 Radiology Ltd. - Green Valley 450 W Continental Rd. Green Valley, AZ 85622 Tel: (520) 625-7670
50 MODALITY BY LOCATION ü ü ü ü ü ü ü GREEN VALLEY Screening only Screening only ü ü ü ü ü ü ü ü ü ü ü ü ü WILMOT ü IMAGING ST. JOSEPH’S ST. ü ü ü ü ü RINCON RADLTD, Screening only Screening only ü ü ü ü ü ü ü RANCHO VISTOSO Screening only Screening only ü ü ü ü ü ü MIDVALE Screening only ü ü ü ü ü ü ü ü ü ü ü ü ü ü LA CHOLLA ü ü ü ü RADLTD, RADLTD, CARONDELET ü ü ü ü ü ü CAMP CAMP LOWELL
3T MRI 3T MRI (High-field) MRI (Espree - Opening) X-Large CT PET / CT Interventional Ultrasound 3D Mammography Digital Mammography Breast Biopsy 3D Upright Breast Biopsy Breast MRI Breast Interventional DEXA (Bone Densitometry) 51 Digital X-ray SCHEDULING CHECKLIST
Centralized Scheduling Phone 520-733-7226 Centralized Scheduling Fax 520-290-8377
Radiology Ltd. takes pride in treating all cases as time-sensitive. Your patient will be scheduled for the first available appointment. To expedite the scheduling process, please use the following guide. Please Send: Patient Demographics o Phone Number o Date of Birth o Insurance Information o Is Authorization Assistance Needed? Order with Exam Type, Reason, and Body Part Supporting Clinical Notes List Prior Imaging Valid Signature and Date If Medically Applicable: o Creatinine Levels o Contrast Allergies o Medical Devices/Implants
STAT cases will be scheduled with urgency.
When requesting STAT, it is best for the Referring Office to Obtain Insurance Authorization to ensure prompt patient care. Call our Authorization Team for guidance. It is helpful to include “Before this date____” on high-priority orders. STAT Scheduling Hotline 520-545-1919 Authorization Guidance 520-901-6767
52 TECHNOLOGY
Radiology Ltd. has a nearly paperless and fully electronic workflow residing on state- of-the-art infrastructure, allowing rapid and seamless communication across locations throughout the organization. We route all imaging studies to the most appropriate location, ensuring the most accurate and timely interpretations and the highest level of patient care. We focus on technological improvements that help us both practice better medicine and optimize customer service.
CURRENT TECHNOLOGIES INCLUDE: (Provider Portal) (Patient Portal) Images are available to the referring Reports and images are available to community within minutes of exam patients 1 business day after their exam is completion and can be viewed read. Our portal is a useful and interactive anywhere, anytime. Our systems enable tool which enables our patients to: our referring providers to: • Preregister for exam and fill out safety • Use different viewers to access questionnaire to expedite check-in images on any platform (one viewer process on the day of exam is for power users; the other is a zero • Access reports and images client viewer that can be used with • Access preparation instructions any browser) for exam, along with the time and • Access current and historical reports location of exam • Find status of patient exams • Access Continuing Care Document • View new services and products, (CCD) including Clinical Decision Support • Communicate directly with Radiology and Alert Application Ltd. staff in a secure, HIPAA-compliant • Order patient exams environment • View new services and products, • Access patient including billing reports from statements and smartphones online bill payment and tablets via our mobile app
53 ACR Appropriateness Criteria
The ACR Appropriateness Criteria® (AC) are evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition. Employing these guidelines helps providers enhance quality of care and contribute to the most efficacious use of radiology.
The list can be found here: https://acsearch.acr.org/list
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58 677 N. Wilmot Rd., Tucson, AZ 85711 . www.radltd.com © Radiology Ltd. 2020
2020 Edition