sign in sign up
<<
Home , Echoencephalography, Portography, Xeroradiography

Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description AUD 92506 Evaluation of speech, language, voice, communication, auditory processing, and/or aural rehabilitation status AUD 92531 Spontaneous nystagmus, including gaze AUD 92532 Positional nystagmus test AUD 92533 Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes four tests) AUD 92534 Optokinetic nystagmus test AUD 92543 Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes four tests), with recording AUD 92546 Sinusoidal vertical axis rotational testing AUD 92548 Computerized dynamic posturography AUD 92551 Screening test, pure tone, air only AUD 92552 Pure tone audiometry (threshold); air only AUD 92553 Pure tone audiometry (threshold); air and bone AUD 92555 Speech audiometry threshold; AUD 92556 Speech audiometry threshold; with speech recognition AUD 92557 Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined) AUD 92559 Audiometric testing of groups AUD 92560 Bekesy audiometry; screening AUD 92561 Bekesy audiometry; diagnostic AUD 92562 Loudness balance test, alternate binaural or monaural AUD 92563 Tone decay test AUD 92564 Short increment sensitivity index (SISI) AUD 92565 Stenger test, pure tone AUD 92567 Tympanometry (impedance testing) AUD 92568 Acoustic reflex testing AUD 92569 Acoustic reflex decay test AUD 92571 Filtered speech test AUD 92572 Staggered spondaic word test AUD 92573 Lombard test AUD 92575 Sensorineural acuity level test AUD 92576 Synthetic sentence identification test AUD 92577 Stenger test, speech AUD 92579 Visual reinforcement audiometry (VRA) AUD 92582 Conditioning play audiometry AUD 92583 Select picture audiometry AUD 92584 Electrocochleography AUD 92585 Auditory evoked potentials for evoked response audiometry and/or testing of the ; comprehensive AUD 92586 Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; limited AUD 92587 Evoked otoacoustic emissions; limited (single stimulus level, either transient or distortion products) Evoked otoacoustic emissions; comprehensive or diagnostic evaluation (comparison of transient and/or distortion product AUD 92588 otoacoustic emissions at multiple levels and frequencies) AUD 92589 Central auditory function test(s) (specify) AUD 92590 Hearing aid examination and selection; monaural AUD 92591 Hearing aid examination and selection; binaural AUD 92592 Hearing aid check; monaural AUD 92593 Hearing aid check; binaural AUD 92594 Electroacoustic evaluation for hearing aid; monaural AUD 92595 Electroacoustic evaluation for hearing aid; binaural AUD 92596 Ear protector attenuation measurements CATS 70450 Computed , head or ; without contrast material CATS 70460 Computed tomography, head or brain; with contrast material(s)

CATS 70470 Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections CATS 70480 Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material CATS 70481 Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by CATS 70482 contrast material(s) and further sections CATS 70486 Computed tomography, maxillofacial area; without contrast material CATS 70487 Computed tomography, maxillofacial area; with contrast material(s) CATS 70488 Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections CATS 70490 Computed tomography, soft tissue neck; without contrast material CATS 70491 Computed tomography, soft tissue neck; with contrast material(s) CATS 70492 Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections CATS 71250 Computed tomography, thorax; without contrast material CATS 71260 Computed tomography, thorax; with contrast material(s) CATS 71270 Computed tomography, thorax; without contrast material, followed by contrast material(s) and further sections CATS 72125 Computed tomography, cervical spine; without contrast material CATS 72126 Computed tomography, cervical spine; with contrast material

CATS 72127 Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections CATS 72128 Computed tomography, thoracic spine; without contrast material CATS 72129 Computed tomography, thoracic spine; with contrast material

CATS 72130 Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections CATS 72131 Computed tomography, lumbar spine; without contrast material CATS 72132 Computed tomography, lumbar spine; with contrast material

CATS 72133 Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Computed tomographic , pelvis, without contrast material(s), followed by contrast material(s) and further CATS 72191 sections, including image post-processing CATS 72192 Computed tomography, pelvis; without contrast material CATS 72193 Computed tomography, pelvis; with contrast material(s) CATS 72194 Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections CATS 73200 Computed tomography, upper extremity; without contrast material CATS 73201 Computed tomography, upper extremity; with contrast material(s) CATS 73202 Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections Computed tomographic angiography, upper extremity, without contrast material(s), followed by contrast material(s) and CATS 73206 further sections, including image post-processing CATS 73700 Computed tomography, lower extremity; without contrast material CATS 73701 Computed tomography, lower extremity; with contrast material(s) CATS 73702 Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections Computed tomographic angiography, lower extremity, without contrast material(s), followed by contrast material(s) and CATS 73706 further sections, including image post-processing CATS 74150 Computed tomography, abdomen; without contrast material CATS 74160 Computed tomography, abdomen; with contrast material(s) CATS 74170 Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections Computed tomographic angiography, abdomen, without contrast material(s) , followed by contrast material(s) and further CATS 74175 sections, including image post-processing Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, radiological supervision and interpretation, without contrast material(s), followed by contrast material(s) and further sections, including CATS 75635 image post-proc Radiological guidance (ie, , ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, CATS 75989 specimen collection), with placement of catheter, radiological supervision and interpretation CATS 76070 Computed tomography bone mineral density study, one or more sites; axial skeleton (eg, hips, pelvis, spine) CATS 76355 Computed tomography guidance for stereotactic localization Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological CATS 76360 supervision and interpretation CATS 76370 Computed tomography guidance for placement of radiation therapy fields CATS 76380 Computed tomography , limited or localized follow-up study CHEST 71010 Radiologic examination, chest; single view, frontal CHEST 71015 Radiologic examination, chest; stereo, frontal CHEST 71020 Radiologic examination, chest, two views, frontal and lateral; DRIP 36430 Transfusion, blood or blood components Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description DRIP 36440 Push transfusion, blood, 2 years or under DRIP 36450 Exchange transfusion, blood; newborn DRIP 36455 Exchange transfusion, blood; other than newborn Intravenous infusion for therapy/diagnosis, administered by physician or under direct supervision of physician; up to one DRIP 90780 hour Intravenous infusion for therapy/diagnosis, administered by physician or under direct supervision of physician; each DRIP 90781 additional hour, up to eight (8) hours (List separately in addition to code for primary procedure) DRIP 90784 Therapeutic or diagnostic injection (specify material injected); intravenous Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological EEG 95805 measurements of sleep during multiple trials to assess sleepiness Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, unattended EEG 95806 by a technologist Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended EEG 95807 by a technologist EEG 95808 ; sleep staging with 1-3 additional parameters of sleep, attended by a technologist EEG 95810 Polysomnography; sleep staging with 4 or more additional parameters of sleep, attended by a technologist Polysomnography; sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway EEG 95811 pressure therapy or bilevel ventilation, attended by a technologist EEG 95812 Electroencephalogram (EEG) extended monitoring; 41-60 minutes EEG 95813 Electroencephalogram (EEG) extended monitoring; greater than one hour EEG 95816 Electroencephalogram (EEG); including recording awake and drowsy EEG 95819 Electroencephalogram (EEG); including recording awake and asleep EEG 95822 Electroencephalogram (EEG); recording in coma or sleep only EEG 95824 Electroencephalogram (EEG); cerebral death evaluation only EEG 95827 Electroencephalogram (EEG); all night recording Monitoring for identification and lateralization of cerebral seizure focus, electroencephalographic (eg, 8 channel EEG) EEG 95950 recording and interpretation, each 24 hours

Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, combined EEG 95951 electroencephalographic (EEG) and video recording and interpretation (eg, for presurgical localization), each 24 hours Monitoring for localization of cerebral seizure focus by computerized portable 16 or more channel EEG; EEG 95953 electroencephalographic (EEG) recording and interpretation, each 24 hours EEG 95955 Electroencephalogram (EEG) during nonintracranial surgery (eg, carotid surgery) Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, EEG 95956 electroencephalographic (EEG) recording and interpretation, each 24 hours EEG 95958 Wada activation test for hemispheric function, including electroencephalographic (EEG) monitoring MAMM 76086 Mammary ductogram or galactogram, single duct, radiological supervision and interpretation MAMM 76088 Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation MAMM 76090 ; unilateral MAMM 76091 Mammography; bilateral MAMM 76092 Screening mammography, bilateral (two view film study of each breast) MAMM 76150 MRI 70240 Radiologic examination, sella turcica MRI 70336 Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) Computed tomographic angiography, head, without contrast material(s), followed by contrast material(s) and further MRI 70496 sections, including image post-processing MRI 70540 Magnetic resonance (eg, proton) imaging, orbit, face, and neck; without contrast material(s) MRI 70542 Magnetic resonance (eg, proton) imaging, orbit, face, and neck; with contrast material(s) Magnetic resonance (eg, proton) imaging, orbit, face, and neck; without contrast material(s), followed by contrast MRI 70543 material(s) and further sequences MRI 70544 Magnetic resonance angiography, head; without contrast material(s) MRI 70545 Magnetic resonance angiography, head; with contrast material(s) Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further MRI 70546 sequences MRI 70547 Magnetic resonance angiography, neck; without contrast material(s) MRI 70548 Magnetic resonance angiography, neck; with contrast material(s) Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further MRI 70549 sequences MRI 70551 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description MRI 70552 Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast MRI 70553 material(s) and further sequences Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without MRI 71550 contrast material(s) Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with MRI 71551 contrast material(s) Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without MRI 71552 contrast material(s), followed by contrast material(s) and further sequences MRI 71555 Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s) MRI 72141 Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material MRI 72142 Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s) MRI 72146 Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material MRI 72147 Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s) MRI 72148 Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material MRI 72149 Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast MRI 72156 material(s) and further sequences; cervical Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast MRI 72157 material(s) and further sequences; thoracic Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast MRI 72158 material(s) and further sequences; lumbar MRI 72159 Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s) MRI 72195 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) MRI 72196 Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further MRI 72197 sequences MRI 72198 Magnetic resonance angiography, pelvis, with or without contrast material(s) MRI 73218 Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s) MRI 73219 Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by MRI 73220 contrast material(s) and further sequences MRI 73221 Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) MRI 73222 Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast MRI 73223 material(s) and further sequences MRI 73225 Magnetic resonance angiography, upper extremity, with or without contrast material(s) MRI 73718 Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) MRI 73719 Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by MRI 73720 contrast material(s) and further sequences MRI 73721 Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material MRI 73722 Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast MRI 73723 material(s) and further sequences MRI 73725 Magnetic resonance angiography, lower extremity, with or without contrast material(s) MRI 74181 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) MRI 74182 Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and MRI 74183 further sequences MRI 74185 Magnetic resonance angiography, abdomen, with or without contrast material(s) MRI 75552 Cardiac magnetic resonance imaging for morphology; without contrast material MRI 75553 Cardiac magnetic resonance imaging for morphology; with contrast material MRI 75554 Cardiac magnetic resonance imaging for function, with or without morphology; complete study MRI 75555 Cardiac magnetic resonance imaging for function, with or without morphology; limited study MRI 75556 Cardiac magnetic resonance imaging for velocity flow mapping MRI 76075 Dual energy x-ray absorptiometry (DEXA), bone density study, one or more sites; axial skeleton (eg, hips, pelvis, spine) Dual energy x-ray absorptiometry (DEXA), bone density study, one or more sites; appendicular skeleton (peripheral) (eg, MRI 76076 radius, wrist, heel) Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description MRI 76078 Radiographic absorptiometry (eg, photodensitometry, radiogrammetry), one or more sites MRI 76093 Magnetic resonance imaging, breast, without and/or with contrast material(s); unilateral MRI 76094 Magnetic resonance imaging, breast, without and/or with contrast material(s); bilateral MRI 76390 Magnetic resonance spectroscopy Magnetic resonance guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of MRI 76393 localization device) radiological supervision and interpretation MRI 76394 Magnetic resonance guidance for, and monitoring of, tissue ablation MRI 76400 Magnetic resonance (eg, proton) imaging, bone marrow blood supply MRI 78350 Bone density (bone mineral content) study, one or more sites; single photon absorptiometry MRI 78351 Bone density (bone mineral content) study, one or more sites; dual photon absorptiometry, one or more sites MRI 78456 Acute venous thrombosis imaging, peptide NUKE 78000 Thyroid uptake; single determination NUKE 78001 Thyroid uptake; multiple determinations NUKE 78003 Thyroid uptake; stimulation, suppression or discharge (not including initial uptake studies) NUKE 78006 Thyroid imaging, with uptake; single determination NUKE 78007 Thyroid imaging, with uptake; multiple determinations NUKE 78010 Thyroid imaging; only NUKE 78011 Thyroid imaging; with vascular flow NUKE 78015 Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) NUKE 78016 Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) NUKE 78018 Thyroid carcinoma metastases imaging; whole body NUKE 78020 Thyroid carcinoma metastases uptake (List separately in addition to code for primary procedure) NUKE 78070 Parathyroid imaging NUKE 78075 Adrenal imaging, cortex and/or medulla NUKE 78102 Bone marrow imaging; limited area NUKE 78103 Bone marrow imaging; multiple areas NUKE 78104 Bone marrow imaging; whole body NUKE 78110 Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling NUKE 78111 Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings NUKE 78120 Red cell volume determination (separate procedure); single sampling NUKE 78121 Red cell volume determination (separate procedure); multiple samplings Whole blood volume determination, including separate measurement of plasma volume and red cell volume NUKE 78122 (radiopharmaceutical volume-dilution technique) NUKE 78130 Red cell survival study; NUKE 78135 Red cell survival study; differential organ/tissue kinetics, (eg, splenic and/or hepatic sequestration) NUKE 78140 Labeled red cell sequestration, differential organ/tissue, (eg, splenic and/or hepatic) NUKE 78160 Plasma radioiron disappearance (turnover) rate NUKE 78162 Radioiron oral absorption NUKE 78170 Radioiron red cell utilization NUKE 78172 Chelatable iron for estimation of total body iron NUKE 78185 Spleen imaging only, with or without vascular flow NUKE 78190 Kinetics, study of platelet survival, with or without differential organ/tissue localization NUKE 78191 Platelet survival study NUKE 78195 Lymphatics and lymph nodes imaging NUKE 78201 imaging; static only NUKE 78202 Liver imaging; with vascular flow NUKE 78205 Liver imaging (SPECT); NUKE 78206 Liver imaging (SPECT); with vascular flow NUKE 78215 Liver and spleen imaging; static only NUKE 78216 Liver and spleen imaging; with vascular flow NUKE 78220 Liver function study with hepatobiliary agents, with serial images Hepatobiliary ductal system imaging, including , with or without pharmacologic intervention, with or without NUKE 78223 quantitative measurement of gallbladder function NUKE 78230 Salivary gland imaging; Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description NUKE 78231 Salivary gland imaging; with serial images NUKE 78232 Salivary gland function study NUKE 78258 Esophageal motility NUKE 78261 Gastric mucosa imaging NUKE 78262 Gastroesophageal reflux study NUKE 78264 Gastric emptying study NUKE 78270 Vitamin B-12 absorption study (eg, ); without intrinsic factor NUKE 78271 vitamin B-12 absorption study (eg, Schilling test); with intrinsic factor NUKE 78272 Vitamin B-12 absorption studies combined, with and without intrinsic factor NUKE 78278 Acute gastrointestinal blood loss imaging NUKE 78282 Gastrointestinal protein loss NUKE 78290 Intestine imaging (eg, ectopic gastric mucosa, Meckels localization, volvulus) NUKE 78291 Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) NUKE 78300 Bone and/or joint imaging; limited area NUKE 78305 Bone and/or joint imaging; multiple areas NUKE 78306 Bone and/or joint imaging; whole body NUKE 78315 Bone and/or joint imaging; three phase study NUKE 78320 Bone and/or joint imaging; tomographic (SPECT) Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without NUKE 78414 pharmacologic intervention or exercise, single or multiple determinations NUKE 78428 Cardiac shunt detection NUKE 78455 Venous thrombosis study (eg, radioactive fibrinogen) NUKE 78457 Venous thrombosis imaging venogram; unilateral NUKE 78458 Venous thrombosis imaging venogram; bilateral NUKE 78459 Myocardial imaging, positron emission tomography (PET), metabolic evaluation Myocardial perfusion imaging; (planar) single study, at rest or stress (exercise and/or pharmacologic), with or without NUKE 78460 quantification Myocardial perfusion imaging; multiple studies, (planar) at rest and/or stress (exercise and/or pharmacologic), and NUKE 78461 redistribution and/or rest injection, with or without quantification Myocardial perfusion imaging; tomographic (SPECT), single study at rest or stress (exercise and/or pharmacologic), with NUKE 78464 or without quantification Myocardial perfusion imaging; tomographic (SPECT), multiple studies, at rest and/or stress (exercise and/or NUKE 78465 pharmacologic) and redistribution and/or rest injection, with or without quantification NUKE 78466 Myocardial imaging, infarct avid, planar; qualitative or quantitative NUKE 78468 Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique NUKE 78469 Myocardial imaging, infarct avid, planar; tomographic SPECT with or without quantification Myocardial perfusion study with wall motion, qualitative or quantitative study (List separately in addition to code for primary NUKE 78478 procedure) NUKE 78480 Myocardial perfusion study with ejection fraction (List separately in addition to code for primary procedure) Cardiac blood pool imaging, (planar) first pass technique; single study, at rest or with stress (exercise and/or NUKE 78481 pharmacologic), wall motion study plus ejection fraction, with or without quantification Cardiac blood pool imaging, (planar) first pass technique; multiple studies, at rest and with stress (exercise and/or NUKE 78483 pharmacologic), wall motion study plus ejection fraction, with or without quantification Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without NUKE 78494 quantitative processing Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass NUKE 78496 technique (List separately in addition to code for primary procedure) NUKE 78580 Pulmonary perfusion imaging, particulate NUKE 78584 Pulmonary perfusion imaging, particulate, with ventilation; single breath NUKE 78585 Pulmonary perfusion imaging, particulate, with ventilation; rebreathing and washout, with or without single breath NUKE 78586 Pulmonary ventilation imaging, aerosol; single projection NUKE 78587 Pulmonary ventilation imaging, aerosol; multiple projections (eg, anterior, posterior, lateral views) NUKE 78588 Pulmonary perfusion imaging, particulate, with ventilation imaging, aerosol, one or multiple projections NUKE 78591 Pulmonary ventilation imaging, gaseous, single breath, single projection

NUKE 78593 Pulmonary ventilation imaging, gaseous, with rebreathing and washout with or without single breath; single projection Pulmonary ventilation imaging, gaseous, with rebreathing and washout with or without single breath; multiple projections NUKE 78594 (eg, anterior, posterior, lateral views) Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description NUKE 78596 Pulmonary quantitative differential function (ventilation/perfusion) study NUKE 78600 Brain imaging, limited procedure; static NUKE 78601 Brain imaging, limited procedure; with vascular flow NUKE 78605 Brain imaging, complete study; static NUKE 78606 Brain imaging, complete study; with vascular flow NUKE 78607 Brain imaging, complete study; tomographic (SPECT) NUKE 78608 Brain imaging, positron emission tomography (PET); metabolic evaluation NUKE 78609 Brain imaging, positron emission tomography (PET); perfusion evaluation NUKE 78610 Brain imaging, vascular flow only NUKE 78615 Cerebral vascular flow NUKE 78630 Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography NUKE 78635 Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography NUKE 78645 Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation NUKE 78647 Cerebrospinal fluid flow, imaging (not including introduction of material); tomographic (SPECT) NUKE 78650 Cerebrospinal fluid leakage detection and localization NUKE 78660 Radiopharmaceutical dacryocystography NUKE 78700 Kidney imaging; static only NUKE 78701 Kidney imaging; with vascular flow NUKE 78704 Kidney imaging; with function study (ie, imaging renogram) NUKE 78707 Kidney imaging with vascular flow and function; single study without pharmacological intervention Kidney imaging with vascular flow and function; single study, with pharmacological intervention (eg, angiotensin converting NUKE 78708 enzyme inhibitor and/or diuretic) Kidney imaging with vascular flow and function; multiple studies, with and without pharmacological intervention (eg, NUKE 78709 angiotensin converting enzyme inhibitor and/or diuretic) NUKE 78710 Kidney imaging; tomographic (SPECT) NUKE 78715 Kidney vascular flow only NUKE 78725 Kidney function study, non-imaging radioisotopic study NUKE 78730 Urinary bladder residual study NUKE 78740 Ureteral reflux study (radiopharmaceutical voiding cystogram) NUKE 78760 Testicular imaging; NUKE 78761 Testicular imaging; with vascular flow NUKE 78799 Unlisted genitourinary procedure, diagnostic nuclear NUKE 78800 Radiopharmaceutical localization of tumor; limited area NUKE 78801 Radiopharmaceutical localization of tumor; multiple areas NUKE 78802 Radiopharmaceutical localization of tumor; whole body NUKE 78803 Radiopharmaceutical localization of tumor; tomographic (SPECT) NUKE 78805 Radiopharmaceutical localization of inflammatory process; limited area NUKE 78806 Radiopharmaceutical localization of inflammatory process; whole body NUKE 78807 Radiopharmaceutical localization of inflammatory process; tomographic (SPECT) NUKE 78810 Tumor imaging, positron emission tomography (PET), metabolic evaluation PT 64550 Application of surface (transcutaneous) neurostimulator PT 90911 Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry PT 93668 Peripheral arterial disease (PAD) rehabilitation, per session PT 93797 Cardiac Rehab Physician services for outpatient cardiac rehabilitation; without continuous ECG monitoring (per session)

PT 93798 Cardiac Rehab Physician services for outpatient cardiac rehabilitation; with continuous ECG monitoring (per session) PT 95831 Muscle testing, manual (separate procedure) with report; extremity (excluding hand) or trunk PT 95832 Muscle testing, manual (separate procedure) with report; hand (with or without comparison with normal side) PT 95833 Muscle testing, manual (separate procedure) with report; total evaluation of body, excluding hands PT 95834 Muscle testing, manual (separate procedure) with report; total evaluation of body, including hands Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section PT 95851 (spine)

PT 95852 Range of motion measurements and report (separate procedure); hand, with or without comparison with normal side PT 95860 Needle electromyography; one extremity with or without related paraspinal areas Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description PT 95861 Needle electromyography; two extremities with or without related paraspinal areas PT 95863 Needle electromyography; three extremities with or without related paraspinal areas PT 95864 Needle electromyography; four extremities with or without related paraspinal areas PT 95867 Needle electromyography; cranial nerve supplied muscle(s), unilateral PT 95868 Needle electromyography; cranial nerve supplied muscles, bilateral PT 95869 Needle electromyography; thoracic paraspinal muscles (excluding T1 or T12) Needle electromyography; limited study of muscles in one extremity or non-limb (axial) muscles (unilateral or bilateral), PT 95870 other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, PT 95872 any/all sites of each muscle studied Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, eg, by Boston Diagnostic Aphasia Examination) with PT 96105 interpretation and repor PT 97001 Physical therapy evaluation PT 97002 Physical therapy re-evaluation PT 97003 Occupational therapy evaluation PT 97004 Occupational therapy re-evaluation PT 97010 Application of a modality to one or more areas; hot or cold packs PT 97012 Application of a modality to one or more areas; traction, mechanical PT 97014 Application of a modality to one or more areas; electrical stimulation (unattended) PT 97018 Application of a modality to one or more areas; paraffin bath PT 97020 Application of a modality to one or more areas; microwave PT 97022 Application of a modality to one or more areas; whirlpool PT 97024 Application of a modality to one or more areas; diathermy PT 97026 Application of a modality to one or more areas; infrared PT 97032 Application of a modality to one or more areas; electrical stimulation (manual), each 15 minutes PT 97034 Application of a modality to one or more areas; contrast baths, each 15 minutes PT 97035 Application of a modality to one or more areas; ultrasound, each 15 minutes PT 97036 Application of a modality to one or more areas; Hubbard tank, each 15 minutes Therapeutic procedure, one or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, PT 97110 range of motion and flexibility Therapeutic procedure, one or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, PT 97112 coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities PT 97113 Therapeutic procedure, one or more areas, each 15 minutes; aquatic therapy with therapeutic exercises PT 97116 Therapeutic procedure, one or more areas, each 15 minutes; gait training (includes stair climbing) Therapeutic procedure, one or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement PT 97124 (stroking, compression, percussion) PT 97139 Therapeutic procedure, one or more areas, each 15 minutes; unlisted therapeutic procedure (specify) Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), one or more PT 97140 regions, each 15 minutes PT 97150 Therapeutic procedure(s), group (2 or more individuals) PT 97504 Orthotics fitting and training, upper extremity(ies), lower extremity(ies), and/or trunk, each 15 minutes PT 97520 Prosthetic training, upper and/or lower extremities, each 15 minutes Therapeutic activities, direct (one on one) patient contact by the provider (use of dynamic activities to improve functional PT 97530 performance), each 15 minutes Self care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one on one contact PT 97535 by provider, eac

Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or PT 97537 work environment/modification analysis, work task analysis), direct one on one contact by provider, each 15 minutes PT 97542 Wheelchair management/propulsion training, each 15 minutes PT 97545 Work hardening/conditioning; initial 2 hours PT 97546 Work hardening/conditioning; each additional hour (List separately in addition to code for primary procedure) PT 97703 Checkout for orthotic/prosthetic use, established patient, each 15 minutes

PT 97750 Physical performance test or measurement (eg, musculoskeletal, functional capacity), with written report, each 15 minutes PT 97799 Unlisted physical medicine/rehabilitation service or procedure Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description PT 98925 Osteopathic manipulative treatment (OMT); one to two body regions involved PT 98926 Osteopathic manipulative treatment (OMT); three to four body regions involved PT 98927 Osteopathic manipulative treatment (OMT); five to six body regions involved PT 98928 Osteopathic manipulative treatment (OMT); seven to eight body regions involved PT 98929 Osteopathic manipulative treatment (OMT); nine to ten body regions involved PT 98940 Chiropractic manipulative treatment (CMT); spinal, one to two regions PT 98941 Chiropractic manipulative treatment (CMT); spinal, three to four regions PT 98942 Chiropractic manipulative treatment (CMT); spinal, five regions PT 98943 Chiropractic manipulative treatment (CMT); extraspinal, one or more regions PUSH 51720 Bladder instillation of anticarcinogenic agent (including detention time) PUSH 90281 Immune globulin (Ig), human, for intramuscular use PUSH 90283 Immune globulin (IgIV), human, for intravenous use PUSH 90291 Cytomegalovirus immune globulin (CMV-IgIV), human, for intravenous use PUSH 90371 Hepatitis B immune globulin (HBIg), human, for intramuscular use PUSH 90375 Rabies immune globulin (RIg), human, for intramuscular and/or subcutaneous use PUSH 90376 Rabies immune globulin, heat-treated (RIg-HT), human, for intramuscular and/or subcutaneous use PUSH 90378 Respiratory syncytial virus immune globulin (RSV-IgIM), for intramuscular use, 50 mg, each PUSH 90379 Respiratory syncytial virus immune globulin (RSV-IgIV), human, for intravenous use PUSH 90384 Rho(D) immune globulin (RhIg), human, full-dose, for intramuscular use PUSH 90385 Rho(D) immune globulin (RhIg), human, mini-dose, for intramuscular use PUSH 90386 Rho(D) immune globulin (RhIgIV), human, for intravenous use PUSH 90389 Tetanus immune globulin (TIg), human, for intramuscular use PUSH 90393 Vaccinia immune globulin, human, for intramuscular use PUSH 90396 Varicella-zoster immune globulin, human, for intramuscular use PUSH 96400 Chemotherapy administration, subcutaneous or intramuscular, with or without local anesthesia PUSH 96405 Chemotherapy administration, intralesional; up to and including 7 lesions PUSH 96406 Chemotherapy administration, intralesional; more than 7 lesions PUSH 96408 Chemotherapy administration, intravenous; push technique PUSH 96410 Chemotherapy administration, intravenous; infusion technique, up to one hour Chemotherapy administration, intravenous; infusion technique, one to 8 hours, each additional hour (List separately in PUSH 96412 addition to code for primary procedure) Chemotherapy administration, intravenous; infusion technique, initiation of prolonged infusion (more than 8 hours), PUSH 96414 requiring the use of a portable or implantable pump PUSH 96420 Chemotherapy administration, intra-arterial; push technique PUSH 96422 Chemotherapy administration, intra-arterial; infusion technique, up to one hour Chemotherapy administration, intra-arterial; infusion technique, one to 8 hours, each additional hour (List separately in PUSH 96423 addition to code for primary procedure) Chemotherapy administration, intra-arterial; infusion technique, initiation of prolonged infusion (more than 8 hours), PUSH 96425 requiring the use of a portable or implantable pump PUSH 96440 Chemotherapy administration into pleural cavity, requiring and including thoracentesis PUSH 96445 Chemotherapy administration into peritoneal cavity, requiring and including peritoneocentesis PUSH 96450 Chemotherapy administration, into CNS (eg, intrathecal), requiring and including spinal puncture RAD 77261 Therapeutic treatment planning; simple RAD 77262 Therapeutic radiology treatment planning; intermediate RAD 77263 Therapeutic radiology treatment planning; complex RAD 77280 Therapeutic radiology simulation-aided field setting; simple RAD 77285 Therapeutic radiology simulation-aided field setting; intermediate RAD 77290 Therapeutic radiology simulation-aided field setting; complex RAD 77295 Therapeutic radiology simulation-aided field setting; three-dimensional Basic radiation dosimetry calculation, central axis depth dose calculation, TDF, NSD, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of RAD 77300 treatment, onl Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance RAD 77301 specifications Teletherapy, isodose plan (whether hand or computer calculated); simple (one or two parallel opposed unmodified ports RAD 77305 directed to a single area of interest) Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description Teletherapy, isodose plan (whether hand or computer calculated); intermediate (three or more treatment ports directed to RAD 77310 a single area of interest) Teletherapy, isodose plan (whether hand or computer calculated); complex (mantle or inverted Y, tangential ports, the use RAD 77315 of wedges, compensators, complex blocking, rotational beam, or special beam considerations) RAD 77321 Special teletherapy port plan, particles, hemi-body, total body Brachytherapy isodose plan; simple (calculation made from single plane, one to four sources/ribbon application, remote RAD 77326 afterloading brachytherapy, 1 to 8 sources) Brachytherapy isodose plan; intermediate (multiplane dosage calculations, application involving five to ten RAD 77327 sources/ribbons, remote afterloading brachytherapy, 9 to 12 sources) Brachytherapy isodose plan; complex (multiplane isodose plan, volume implant calculations, over ten sources/ribbons RAD 77328 used, special spatial reconstruction, remote afterloading brachytherapy, over 12 sources) RAD 77331 Special dosimetry (eg, TLD, microdosimetry) (specify), only when prescribed by the treating physician RAD 77332 Treatment devices, design and construction; simple (simple block, simple bolus) RAD 77333 Treatment devices, design and construction; intermediate (multiple blocks, , bite blocks, special bolus) Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or RAD 77334 casts) RAD 77370 Special medical radiation physics consultation RAD 77401 Radiation treatment delivery, superficial and/or ortho voltage Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks; up to RAD 77402 5 MeV Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks; 6-10 RAD 77403 MeV Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks; 11-19 RAD 77404 MeV Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks; 20 RAD 77406 MeV or greater Radiation treatment delivery, two separate treatment areas, three or more ports on a single treatment area, use of multiple RAD 77407 blocks; up to 5 MeV Radiation treatment delivery, two separate treatment areas, three or more ports on a single treatment area, use of multiple RAD 77408 blocks; 6-10 MeV Radiation treatment delivery, two separate treatment areas, three or more ports on a single treatment area, use of multiple RAD 77409 blocks; 11-19 MeV Radiation treatment delivery, two separate treatment areas, three or more ports on a single treatment area, use of multiple RAD 77411 blocks; 20 MeV or greater Radiation treatment delivery, three or more separate treatment areas, custom blocking, tangential ports, wedges, RAD 77412 rotational beam, compensators, special particle beam (eg, electron or neutrons); up to 5 MeV Radiation treatment delivery, three or more separate treatment areas, custom blocking, tangential ports, wedges, RAD 77413 rotational beam, compensators, special particle beam (eg, electron or neutrons); 6-10 MeV Radiation treatment delivery, three or more separate treatment areas, custom blocking, tangential ports, wedges, RAD 77414 rotational beam, compensators, special particle beam (eg, electron or neutrons); 11-19 MeV Radiation treatment delivery, three or more separate treatment areas, custom blocking, tangential ports, wedges, RAD 77416 rotational beam, compensators, special particle beam (eg, electron or neutrons); 20 MeV or greater RAD 77417 Therapeutic radiology port film(s) Intensity modulated treatment delivery, single or multiple fields/arcs, via narrow spatially and temporally modulated beams RAD 77418 (eg, binary, dynamic MLC), per treatment session RAD 77431 Radiation therapy management with complete course of therapy consisting of one or two fractions only Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral, endocavitary or intraoperative cone RAD 77470 irradiation) RAD 77520 Proton treatment delivery; simple, without compensation RAD 77522 Proton treatment delivery; simple, with compensation RAD 77523 Proton treatment delivery; intermediate RAD 77525 Proton treatment delivery; complex RAD 77750 Infusion or instillation of radioelement solution RAD 77761 Intracavitary radiation source application; simple RAD 77762 Intracavitary radiation source application; intermediate RAD 77763 Intracavitary radiation source application; complex RAD 77776 Interstitial radiation source application; simple RAD 77777 Interstitial radiation source application; intermediate RAD 77778 Interstitial radiation source application; complex RAD 77781 Remote afterloading high intensity brachytherapy; 1-4 source positions or catheters RAD 77782 Remote afterloading high intensity brachytherapy; 5-8 source positions or catheters Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description RAD 77783 Remote afterloading high intensity brachytherapy; 9-12 source positions or catheters RAD 77784 Remote afterloading high intensity brachytherapy; over 12 source positions or catheters RAD 77789 Surface application of radiation source RAD 79000 Radiopharmaceutical therapy, hyperthyroidism; initial, including evaluation of patient RAD 79001 Radiopharmaceutical therapy, hyperthyroidism; subsequent, each therapy RAD 79020 Radiopharmaceutical therapy, thyroid suppression (euthyroid cardiac disease), including evaluation of patient RAD 79030 Radiopharmaceutical ablation of gland for thyroid carcinoma RAD 79035 Radiopharmaceutical therapy for metastases of thyroid carcinoma RAD 79100 Radiopharmaceutical therapy, polycythemia vera, chronic leukemia, each treatment RAD 79200 Intracavitary radioactive colloid therapy RAD 79300 Interstitial radioactive colloid therapy RAD 79400 Radiopharmaceutical therapy, nonthyroid, nonhematologic RAD 79420 Intravascular radiopharmaceutical therapy, particulate RAD 79440 Intra-articular radiopharmaceutical therapy Treatment of speech, language, voice, communication, and/or auditory processing disorder (includes aural rehabilitation); SPEEC 92507 individual Treatment of speech, language, voice, communication, and/or auditory processing disorder (includes aural rehabilitation); SPEEC 92508 group, two or more individuals Aural rehabilitation following cochlear implant (includes evaluation of aural rehabilitation status and hearing, therapeutic SPEEC 92510 services) with or without speech processor programming Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall STRES 78472 motion study plus ejection fraction, with or without additional quantitative processing Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress STRES 78473 (exercise and/or pharmacologic), with or without additional quantification Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic STRES 93015 monitoring, and/or pharmacological stress; with physician supervision, with interpretation and report (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; initial vessel ULTRA 37250 (List separately in addition to code for primary procedure) Intrasvascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; each ULTRA 37251 additional vessel (List separately in addition to code for primary procedure) , B-scan and/or real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents and detection of fluid masses or other intracranial abnormalities), including A-mode ULTRA 76506 encephalograph ULTRA 76511 Ophthalmic ultrasound, echography, diagnostic; A-scan only, with amplitude quantification ULTRA 76512 Ophthalmic ultrasound, echography, diagnostic; contact B-scan (with or without simultaneous A-scan) Ophthalmic ultrasound, echography, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high ULTRA 76513 resolution biomicroscopy ULTRA 76516 Ophthalmic biometry by ultrasound echography, A-scan; ULTRA 76519 Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation ULTRA 76529 Ophthalmic ultrasonic foreign body localization Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), B-scan and/or real time with image ULTRA 76536 documentation ULTRA 76604 Ultrasound, chest, B-scan (includes mediastinum) and/or real time with image documentation ULTRA 76645 Ultrasound, breast(s) (unilateral or bilateral), B-scan and/or real time with image documentation ULTRA 76700 Ultrasound, abdominal, B-scan and/or real time with image documentation; complete ULTRA 76705 Ultrasound, abdominal, B-scan and/or real time with image documentation; limited (eg, single organ, quadrant, follow-up) ULTRA 76770 Ultrasound, retroperitoneal (eg, renal, aorta, nodes), B-scan and/or real time with image documentation; complete ULTRA 76775 Ultrasound, retroperitoneal (eg, renal, aorta, nodes), B-scan and/or real time with image documentation; limited Ultrasound of transplanted kidney, B-scan and/or real time with image documentation, with or without duplex Doppler ULTRA 76778 studies ULTRA 76800 Ultrasound, spinal canal and contents Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = ULTRA 76805 14 weeks 0 days), transabdominal approach; single or first gestation Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List separately in addition to code for primary ULTRA 76810 procedure p Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal ULTRA 76815 position, and/or qualitative amniotic fluid volume), one or more fetuses Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be ULTRA 76816 abnormal on a prev ULTRA 76818 Fetal biophysical profile; with non-stress testing ULTRA 76819 Fetal biophysical profile; without non-stress testing , fetal, cardiovascular system, real time with image documentation (2D) with or without M-mode ULTRA 76825 recording; Echocardiography, fetal, cardiovascular system, real time with image documentation (2D) with or without M-mode ULTRA 76826 recording; follow-up or repeat study , fetal, cardiovascular system, pulsed wave and/or continuous wave with spectral display; ULTRA 76827 complete Doppler echocardiography, fetal, cardiovascular system, pulsed wave and/or continuous wave with spectral display; follow- ULTRA 76828 up or repeat study ULTRA 76830 Ultrasound, transvaginal ULTRA 76831 Hysterosonography, with or without color flow Doppler ULTRA 76856 Ultrasound, pelvic (nonobstetric), B-scan and/or real time with image documentation; complete ULTRA 76857 Ultrasound, pelvic (nonobstetric), B-scan and/or real time with image documentation; limited or follow-up (eg, for follicles) ULTRA 76870 Ultrasound, scrotum and contents ULTRA 76872 Echography, transrectal; ULTRA 76880 Ultrasound, extremity, non-vascular, B-scan and/or real time with image documentation ULTRA 76885 Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician manipulation) ULTRA 76886 Ultrasound infant hips, real time with imaging documentation; limited, static (not requiring physician manipulation) ULTRA 76970 Ultrasound study follow-up (specify) ULTRA 76975 Gastrointestinal , supervision and interpretation

Intravascular ultrasound (coronary vessel or graft) during diagnostic evaluation and/or therapeutic intervention including ULTRA 92978 imaging supervision, interpretation and report; initial vessel (List separately in addition to code for primary procedure) Intrasvascular ultrasound (coronary vessel or graft) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (List separately in addition to code for primary ULTRA 92979 procedure) ULTRA 93303 Transthoracic echocardiography for congenital cardiac anomalies; complete ULTRA 93304 Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study ULTRA 93307 Echocardiography, transthoracic, real-time with image documentation (2D) with or without M-mode recording; complete Echocardiography, transthoracic, real-time with image documentation (2D) with or without M-mode recording; follow-up or ULTRA 93308 limited study Echocardiography, transesophageal, real time with image documentation (2D) (with or without M-mode recording); ULTRA 93312 including probe placement, image acquisition, interpretation and report Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, ULTRA 93315 interpretation and report Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac ULTRA 93318 pumping function and to t Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes ULTRA 93320 for echocardiographic imaging); complete Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes for echocardiographic imaging); follow-up or limited study (List separately in addition to codes for echocardiographic ULTRA 93321 imaging) ULTRA 93325 Doppler echocardiography color flow velocity mapping (List separately in addition to codes for echocardiography) Echocardiography, transthoracic, real-time with image documentation (2D, with or without M-mode recording), during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation ULTRA 93350 and repor Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress; initial vessel (List separately in addition to code ULTRA 93571 for primary pro Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress; each additional vessel(List separately in addition ULTRA 93572 to code for prim Noninvasive physiologic studies of extracranial , complete bilateral study (eg, periorbital flow direction with arterial ULTRA 93875 compression, ocular pneumoplethysmography, Doppler ultrasound spectral analysis) ULTRA 93880 Duplex scan of extracranial arteries; complete bilateral study ULTRA 93882 Duplex scan of extracranial arteries; unilateral or limited study ULTRA 93886 study of the intracranial arteries; complete study Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description ULTRA 93888 Transcranial Doppler study of the intracranial arteries; limited study Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral (eg, ankle/brachial indices, ULTRA 93922 Doppler waveform analysis, volume plethysmography, transcutaneous oxygen tension measurement) Non-invasive physiologic studies of upper or lower extremity arteries, multiple levels or with provocative functional maneuvers, complete bilateral study (eg, segmental blood pressure measurements, segmental Doppler waveform ULTRA 93923 analysis, segmental volume ple Non-invasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, complete bilateral ULTRA 93924 study ULTRA 93925 Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study ULTRA 93926 Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study ULTRA 93930 Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study ULTRA 93931 Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study Non-invasive physiologic studies of extremity , complete bilateral study (eg, Doppler waveform analysis with ULTRA 93965 responses to compression and other maneuvers, phleborheography, impedance plethysmography) ULTRA 93970 Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study

ULTRA 93971 Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; ULTRA 93975 complete study Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; ULTRA 93976 limited study ULTRA 93978 Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study ULTRA 93979 Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study ULTRA 93980 Duplex scan of arterial inflow and venous outflow of penile vessels; complete study ULTRA 93981 Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study ULTRA 93990 Duplex scan of access (including arterial inflow, body of access and venous outflow) VASCU 75658 Angiography, brachial, retrograde, radiological supervision and interpretation VASCU 75660 Angiography, external carotid, unilateral, selective, radiological supervision and interpretation VASCU 75662 Angiography, external carotid, bilateral, selective, radiological supervision and interpretation VASCU 75665 Angiography, carotid, cerebral, unilateral, radiological supervision and interpretation VASCU 75671 Angiography, carotid, cerebral, bilateral, radiological supervision and interpretation VASCU 75676 Angiography, carotid, cervical, unilateral, radiological supervision and interpretation VASCU 75680 Angiography, carotid, cervical, bilateral, radiological supervision and interpretation VASCU 75705 Angiography, spinal, selective, radiological supervision and interpretation VASCU 75710 Angiography, extremity, unilateral, radiological supervision and interpretation VASCU 75716 Angiography, extremity, bilateral, radiological supervision and interpretation Angiography, visceral, selective or supraselective, (with or without flush aortogram), radiological supervision and VASCU 75726 interpretation VASCU 75731 Angiography, adrenal, unilateral, selective, radiological supervision and interpretation VASCU 75733 Angiography, adrenal, bilateral, selective, radiological supervision and interpretation VASCU 75736 Angiography, pelvic, selective or supraselective, radiological supervision and interpretation VASCU 75741 Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation VASCU 75743 Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation VASCU 75746 Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation VASCU 75756 Angiography, internal mammary, radiological supervision and interpretation Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation VASCU 75774 (List separately in addition to code for primary procedure) VASCU 75790 Angiography, arteriovenous shunt (eg, dialysis patient), radiological supervision and interpretation VASCU 75801 Lymphangiography, extremity only, unilateral, radiological supervision and interpretation VASCU 75803 Lymphangiography, extremity only, bilateral, radiological supervision and interpretation VASCU 75805 Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation VASCU 75807 Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation VASCU 75810 Splenoportography, radiological supervision and interpretation VASCU 75825 , caval, inferior, with serialography, radiological supervision and interpretation VASCU 75827 Venography, caval, superior, with serialography, radiological supervision and interpretation VASCU 75831 Venography, renal, unilateral, selective, radiological supervision and interpretation VASCU 75833 Venography, renal, bilateral, selective, radiological supervision and interpretation Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description VASCU 75840 Venography, adrenal, unilateral, selective, radiological supervision and interpretation VASCU 75842 Venography, adrenal, bilateral, selective, radiological supervision and interpretation VASCU 75860 Venography, sinus or jugular, catheter, radiological supervision and interpretation VASCU 75870 Venography, superior sagittal sinus, radiological supervision and interpretation VASCU 75872 Venography, epidural, radiological supervision and interpretation VASCU 75880 Venography, orbital, radiological supervision and interpretation VASCU 75885 Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation VASCU 75887 Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation VASCU 75889 Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation VASCU 75891 Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation VASCU 75898 Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion VASCU 75940 Percutaneous placement of IVC filter, radiological supervision and interpretation VASCU 78445 Non-cardiac vascular flow imaging (ie, angiography, venography) Injection procedure during cardiac catheterization; for selective opacification of arterial conduits (eg, internal mammary), VASCU 93539 whether native or used for bypass Injection procedure during cardiac catheterization; for selective opacification of aortocoronary venous bypass grafts, one or VASCU 93540 more coronary arteries VASCU 93541 Injection procedure during cardiac catheterization; for pulmonary angiography VASCU 93542 Injection procedure during cardiac catheterization; for selective right ventricular or right atrial angiography VASCU 93543 Injection procedure during cardiac catheterization; for selective left ventricular or left atrial angiography VASCU 93544 Injection procedure during cardiac catheterization; for Injection procedure during cardiac catheterization; for selective coronary angiography (injection of radiopaque material VASCU 93545 may be by hand) Imaging supervision, interpretation and report for injection procedure(s) during cardiac catheterization; ventricular and/or VASCU 93555 atrial angiography Imaging supervision, interpretation and report for injection procedure(s) during cardiac catheterization; pulmonary angiography, aortography, and/or selective coronary angiography including venous bypass grafts and arterial conduits VASCU 93556 (whether native or use XRAY 70010 , posterior fossa, radiological supervision and interpretation XRAY 70015 Cisternography, positive contrast, radiological supervision and interpretation XRAY 70030 Radiologic examination, eye, for detection of foreign body XRAY 70100 Radiologic examination, mandible; partial, less than four views XRAY 70110 Radiologic examination, mandible; complete, minimum of four views XRAY 70120 Radiologic examination, mastoids; less than three views per side XRAY 70130 Radiologic examination, mastoids; complete, minimum of three views per side XRAY 70134 Radiologic examination, internal auditory meati, complete XRAY 70140 Radiologic examination, facial bones; less than three views XRAY 70150 Radiologic examination, facial bones; complete, minimum of three views XRAY 70160 Radiologic examination, nasal bones, complete, minimum of three views XRAY 70170 Dacryocystography, nasolacrimal duct, radiological supervision and interpretation XRAY 70190 Radiologic examination; optic foramina XRAY 70200 Radiologic examination; orbits, complete, minimum of four views XRAY 70210 Radiologic examination, sinuses, paranasal, less than three views XRAY 70220 Radiologic examination, sinuses, paranasal, complete, minimum of three views XRAY 70250 Radiologic examination, ; less than four views, with or without stereo XRAY 70260 Radiologic examination, skull; complete, minimum of four views, with or without stereo XRAY 70328 Radiologic examination, temporomandibular joint, open and closed mouth; unilateral XRAY 70330 Radiologic examination, temporomandibular joint, open and closed mouth; bilateral XRAY 70332 Temporomandibular joint arthrography, radiological supervision and interpretation XRAY 70360 Radiologic examination; neck, soft tissue XRAY 70370 Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique XRAY 70371 Complex dynamic pharyngeal and speech evaluation by cine or video recording XRAY 70373 Laryngography, contrast, radiological supervision and interpretation XRAY 70380 Radiologic examination, salivary gland for calculus XRAY 70390 , radiological supervision and interpretation Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description XRAY 71021 Radiologic examination, chest, two views, frontal and lateral; with apical lordotic procedure XRAY 71022 Radiologic examination, chest, two views, frontal and lateral; with oblique projections XRAY 71023 Radiologic examination, chest, two views, frontal and lateral; with fluoroscopy XRAY 71030 Radiologic examination, chest, complete, minimum of four views; XRAY 71034 Radiologic examination, chest, complete, minimum of four views; with fluoroscopy XRAY 71035 Radiologic examination, chest, special views (eg, lateral decubitus, Bucky studies) XRAY 71040 , unilateral, radiological supervision and interpretation XRAY 71060 Bronchography, bilateral, radiological supervision and interpretation XRAY 71100 Radiologic examination, ribs, unilateral; two views XRAY 71101 Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of three views XRAY 71110 Radiologic examination, ribs, bilateral; three views XRAY 71111 Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of four views XRAY 71120 Radiologic examination; sternum, minimum of two views XRAY 71130 Radiologic examination; sternoclavicular joint or joints, minimum of three views XRAY 72010 Radiologic examination, spine, entire, survey study, anteroposterior and lateral XRAY 72020 Radiologic examination, spine, single view, specify level XRAY 72040 Radiologic examination, spine, cervical; two or three views XRAY 72050 Radiologic examination, spine, cervical; minimum of four views XRAY 72052 Radiologic examination, spine, cervical; complete, including oblique and flexion and/or extension studies XRAY 72069 Radiologic examination, spine, thoracolumbar, standing (scoliosis) XRAY 72070 Radiologic examination, spine; thoracic, two views XRAY 72072 Radiologic examination, spine; thoracic, three views XRAY 72074 Radiologic examination, spine; thoracic, minimum of four views XRAY 72080 Radiologic examination, spine; thoracolumbar, two views XRAY 72090 Radiologic examination, spine; scoliosis study, including supine and erect studies XRAY 72100 Radiologic examination, spine, lumbosacral; two or three views XRAY 72110 Radiologic examination, spine, lumbosacral; minimum of four views XRAY 72114 Radiologic examination, spine, lumbosacral; complete, including bending views XRAY 72120 Radiologic examination, spine, lumbosacral, bending views only, minimum of four views XRAY 72170 Radiologic examination, pelvis; one or two views XRAY 72190 Radiologic examination, pelvis; complete, minimum of three views XRAY 72200 Radiologic examination, sacroiliac joints; less than three views XRAY 72202 Radiologic examination, sacroiliac joints; three or more views XRAY 72220 Radiologic examination, sacrum and coccyx, minimum of two views XRAY 72240 Myelography, cervical, radiological supervision and interpretation XRAY 72255 Myelography, thoracic, radiological supervision and interpretation XRAY 72265 Myelography, lumbosacral, radiological supervision and interpretation XRAY 72270 Myelography, entire spinal canal, radiological supervision and interpretation XRAY 72285 Diskography, cervical or thoracic, radiological supervision and interpretation XRAY 72295 Diskography, lumbar, radiological supervision and interpretation XRAY 73000 Radiologic examination; clavicle, complete XRAY 73010 Radiologic examination; scapula, complete XRAY 73020 Radiologic examination, shoulder; one view XRAY 73030 Radiologic examination, shoulder; complete, minimum of two views XRAY 73040 Radiologic examination, shoulder, arthrography, radiological supervision and interpretation XRAY 73050 Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction XRAY 73060 Radiologic examination; humerus, minimum of two views XRAY 73070 Radiologic examination, elbow; two views XRAY 73080 Radiologic examination, elbow; complete, minimum of three views XRAY 73085 Radiologic examination, elbow, arthrography, radiological supervision and interpretation XRAY 73090 Radiologic examination forearm; two views XRAY 73092 Radiologic examination forearm; upper extremity, infant, minimum of two views XRAY 73100 Radiologic examination, wrist; two views Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description XRAY 73115 Radiologic examination, wrist, arthrography, radiological supervision and interpretation XRAY 73120 Radiologic examination, hand; two views XRAY 73130 Radiologic examination, hand; minimum of three views XRAY 73140 Radiologic examination, finger(s), minimum of two views XRAY 73500 Radiologic examination, hip unilateral; one view XRAY 73510 Radiologic examination, hip unilateral; complete, minimum of two views XRAY 73520 Radiologic examination, hips, bilateral, minimum of two views of each hip, including anteroposterior view of pelvis XRAY 73525 Radiologic examination, hip, arthrography, radiological supervision and interpretation XRAY 73530 Radiologic examination, hip, during operative procedure XRAY 73540 Radiologic examination, pelvis and hips, infant or child, minimum of two views XRAY 73542 Radiological examination, sacroiliac joint arthrography, radiological supervision and interpretation XRAY 73550 Radiologic examination, femur, two views XRAY 73560 Radiologic examination, knee; one or two views XRAY 73562 Radiologic examination, knee; three views XRAY 73564 Radiologic examination, knee; complete, four or more views XRAY 73565 Radiologic examination, knee; both knees, standing, anteroposterior XRAY 73580 Radiologic examination, knee, arthrography, radiological supervision and interpretation XRAY 73590 Radiologic examination; tibia and fibula, two views XRAY 73592 Radiologic examination; lower extremity, infant, minimum of two views XRAY 73600 Radiologic examination, ankle; two views XRAY 73610 Radiologic examination, ankle; complete, minimum of three views XRAY 73615 Radiologic examination, ankle, arthrography, radiological supervision and interpretation XRAY 73620 Radiologic examination, foot; two views XRAY 73630 Radiologic examination, foot; complete, minimum of three views XRAY 73650 Radiologic examination; calcaneus, minimum of two views XRAY 73660 Radiologic examination; toe(s), minimum of two views XRAY 74000 Radiologic examination, abdomen; single anteroposterior view XRAY 74010 Radiologic examination, abdomen; anteroposterior and additional oblique and cone views XRAY 74020 Radiologic examination, abdomen; complete, including decubitus and/or erect views Radiologic examination, abdomen; complete acute abdomen series, including supine, erect, and/or decubitus views, single XRAY 74022 view chest XRAY 74190 Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation XRAY 74210 Radiologic examination; pharynx and/or cervical XRAY 74220 Radiologic examination; esophagus XRAY 74230 Swallowing function, with cineradiography/videoradiography XRAY 74240 Radiologic examination, , upper; with or without delayed films, without KUB XRAY 74241 Radiologic examination, gastrointestinal tract, upper; with or without delayed films, with KUB XRAY 74245 Radiologic examination, gastrointestinal tract, upper; with , includes multiple serial films Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, XRAY 74246 with or without glucagon; with or without delayed films, without KUB Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, XRAY 74247 with or without glucagon; with or without delayed films, with KUB Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, XRAY 74249 with or without glucagon; with small intestine follow-through XRAY 74250 Radiologic examination, small intestine, includes multiple serial films; XRAY 74251 Radiologic examination, small bowel, includes multiple serial films; via enteroclysis tube XRAY 74260 Duodenography, hypotonic XRAY 74270 Radiologic examination, colon; barium enema, with or without KUB XRAY 74280 Radiologic examination, colon; air contrast with specific high density barium, with or without glucagon XRAY 74290 , oral contrast; XRAY 74291 Cholecystography, oral contrast; additional or repeat examination or multiple day examination XRAY 74300 and/or pancreatography; intraoperative, radiological supervision and interpretation XRAY 74305 Cholangiography and/or pancreatography; through existing catheter, radiological supervision and interpretation XRAY 74320 Cholangiography, percutaneous, transhepatic, radiological supervision and interpretation XRAY 74400 Urography (pyelography), intravenous, with or without KUB, with or without tomography Products of Ambulatory Care 2004 Procedure Codes

KeyTech CPT CPT Description XRAY 74410 Urography, infusion, drip technique and/or bolus technique; XRAY 74415 Urography, infusion, drip technique and/or bolus technique; with nephrotomography XRAY 74420 Urography, retrograde, with or without KUB XRAY 74425 Urography, antegrade, (pyelostogram, nephrostogram, loopogram), radiological supervision and interpretation XRAY 74430 , minimum of three views, radiological supervision and interpretation XRAY 74440 Vasography, vesiculography, or epididymography, radiological supervision and interpretation XRAY 74445 Corpora cavernosography, radiological supervision and interpretation XRAY 74450 Urethrocystography, retrograde, radiological supervision and interpretation XRAY 74455 Urethrocystography, voiding, radiological supervision and interpretation XRAY 74470 Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation XRAY 74710 Pelvimetry, with or without placental localization XRAY 74740 , radiological supervision and interpretation XRAY 74742 Transcervical catheterization of fallopian tube, radiological supervision and interpretation XRAY 74775 Perineogram (eg, vaginogram, for sex determination or extent of anomalies) Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal XRAY 75809 shunt, indwelling infusion pump), radiological supervision and interpretation XRAY 75820 Venography, extremity, unilateral, radiological supervision and interpretation XRAY 76010 Radiologic examination from nose to for foreign body, single view, child XRAY 76020 Bone age studies XRAY 76040 Bone length studies (orthoroentgenogram, scanogram) XRAY 76061 Radiologic examination, osseous survey; limited (eg, for metastases) XRAY 76062 Radiologic examination, osseous survey; complete (axial and appendicular skeleton) XRAY 76065 Radiologic examination, osseous survey, infant XRAY 76066 Joint survey, single view, two or more joints (specify) XRAY 76080 Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation XRAY 76100 Radiologic examination, single plane body section (eg, tomography), other than with urography Radiologic examination, complex motion (ie, hypercycloidal) body section (eg, mastoid polytomography), other than with XRAY 76101 urography; unilateral Radiologic examination, complex motion (ie, hypercycloidal) body section (eg, mastoid polytomography), other than with XRAY 76102 urography; bilateral XRAY 76120 Cineradiography/videoradiography, except where specifically included Cineradiography/videoradiography to complement routine examination (List separately in addition to code for primary XRAY 76125 procedure) XRAY 76499 Unlisted diagnostic radiographic procedure XRAY 78491 Myocardial imaging, positron emission tomography (PET), perfusion; single study at rest or stress XRAY 78492 Myocardial imaging, positron emission tomography (PET), perfusion; multiple studies at rest and/or stress XRAY 92230 Fluorescein with interpretation and report XRAY 92235 (includes multiframe imaging) with interpretation and report XRAY 92240 Indocyanine-green angiography (includes multiframe imaging) with interpretation and report XRAY 92287 Special anterior segment photography with interpretation and report; with fluorescein angiography XRAY 94772 Circadian respiratory pattern recording (pediatric pneumogram)