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BRAIN/HEAD BRAIN NO CONTRAST-CT CT Head Without Contrast 70450 1 NCH Radiology Procedure Name List CT Effective November 5, 2016 CURRENT EPIC PROCEDURE NAME CPT Code Review New with Epic Name (Orderables) (Orderables) (Chargeables) BRAIN/HEAD BRAIN NO CONTRAST-CT CT Head without Contrast 70450 BRAIN CONTRAST - CT CT Head with Contrast 70460 BRAIN DUAL - CT CT Head without then with Contrast 70470 CT Angiography BRAIN CONTRAST CT Head Angiography with Contrast 70496 CT Head Angiography without then with Contrast 70496 CT Head Stealth with Contrast 70460 CT Head Stealth without Contrast 70450 CT Head Limited Low Dose without Contrast 70450-52 CT Head ECMO 70450 INNER EAR INNER EAR NO CONTRAST - CT CT Temporal Bones without Contrast 70480 INNER EAR CONTRAST - CT CT Temporal Bones with Contrast 70481 NCH Radiology Procedure Name List CT Effective November 5, 2016 CURRENT EPIC PROCEDURE NAME CPT Code Review New with Epic Name (Orderables) (Orderables) (Chargeables) INNER EAR DUAL - CT CT Temporal Bones with Contrast 70482 FACIAL/SINUSES ORBITS NO CONTRAST - CT CT Orbits without Contrast 70480 ORBITS CONTRAST - CT CT Orbits with Contrast 70481 ORBITS DUAL - CT CT Orbits without Contrast 70482 SINUSES NO CONTRAST - CT CT Sinuses without Contrast 70486 CT Sinuses Stealth without Contrast 70486 SINUSES CONTRAST - CT CT Sinuses with Contrast 70487 CT Sinuses Stealth with Contrast 70487 FACIAL BONES NO CONTRAST - CT CT Face without Contrast 70486 FACIAL BONES CONTRAST - CT CT Face with Contrast 70487 FACIAL BONES DUAL - CT CT Face with Contrast 70488 NCH Radiology Procedure Name List CT Effective November 5, 2016 CURRENT EPIC PROCEDURE NAME CPT Code Review New with Epic Name (Orderables) (Orderables) (Chargeables) NECK/C-SPINE NECK NO CONTRAST - CT CT Neck without Contrast 70490 NECK CONTRAST - CT CT Neck with Contrast 70491 CT Angiography NECK CONTRAST CT Neck Angiography with Contrast 70498 C-SPINE NO CONTRAST - CT CT Spine Cervical without Contrast 72125 C-SPINE CONTRAST - CT CT Spine Cervical with Contrast 72126 CT Spine Cervical Dynamic Without Contrast 72125 70491 CHEST/NECK CONTRAST - CT CT Neck Chest with Contrast 71260 CHEST/CARDIAC CHEST NO CONTRAST - CT CT Chest without Contrast 71250 CHEST CONTRAST - CT CT Chest with Contrast 71260 CT Angiography CHEST CT Chest Angiography Contrast 71275 NCH Radiology Procedure Name List CT Effective November 5, 2016 CURRENT EPIC PROCEDURE NAME CPT Code Review New with Epic Name (Orderables) (Orderables) (Chargeables) CT Chest Cardiac Anatomy 75572 CT Chest Cardiac CHD Function 75573 CT Chest Cardiac Function 75574 CT Chest with Dynamic Airway 71250 BACK/SPINE THORACIC SPINE NO CONTRAST - CT CT Spine Thoracic without Contrast 72128 THORACIC SPINE CONTRAST - CT CT Spine Thoracic with Contrast 72129 LUMBAR SPINE NO CONTRAST - CT CT Spine Lumbar without Contrast 72131 LUMBAR SPINE CONTRAST - CT CT Spine Lumbar with Contrast 72132 CT Lumbar Bone Density 77078 NCH Radiology Procedure Name List CT Effective November 5, 2016 CURRENT EPIC PROCEDURE NAME CPT Code Review New with Epic Name (Orderables) (Orderables) (Chargeables) SPINE COMBOS 72125 CT Spine Cervical Thoracic without Contrast 72128 72125 CT Spine Cervical Thoracic Lumbar without Contrast 72128 72131 72126 CT Spine Cervical Thoracic with Contrast 72129 72126 CT Spine Cervical Thoracic Lumbar with Contrast 72129 72132 CT Spine Thoracic Lumbar with Contrast 72129 & 72132 CT Spine Thoracic Lumbar without Contrast 72128 & 72131 NCH Radiology Procedure Name List CT Effective November 5, 2016 CURRENT EPIC PROCEDURE NAME CPT Code Review New with Epic Name (Orderables) (Orderables) (Chargeables) PELVIS/HIP CT Angiography PELVIS CT Pelvis Angiography 72191 PELVIS NO CONTRAST - CT CT Pelvis without Contrast 72192 PELVIS (IV ONLY) - CT CT Pelvis with IV Contrast 72191 PELVIS (ORAL ONLY) - CT CT Pelvis Oral Contrast Only 72192 PELVIS (ORAL-IV) - CT CT Pelvis with IV and Oral Contrast 72193 CT Hip Right without Contrast 73700 CT Hip Left without Contrast 73700 CT Hip Bilateral without Contrast 73700-50 CT Hip Left with Contrast 73701 CT Hip Right with Contrast 73701 CT Hip Bilateral with Contrast 73701-50 NCH Radiology Procedure Name List CT Effective November 5, 2016 CURRENT EPIC PROCEDURE NAME CPT Code Review New with Epic Name (Orderables) (Orderables) (Chargeables) UPPER EXT CT Upper Extremity Angiography Left with Contrast 73206 CT Upper Extremity Angiography Right with Contrast 73206 CT Upper Extremity Angiography Bilateral with Contrast 73206-50 SHOULDER CT Shoulder Left without Contrast 73200 CT Shoulder Right without Contrast 73200 CT Shoulder Bilateral without Contrast 73200-50 CT Shoulder Left with Contrast 73201 CT Shoulder Right with Contrast 73201 CT Shoulder Bilateral with Contrast 73201-50 NCH Radiology Procedure Name List CT Effective November 5, 2016 CURRENT EPIC PROCEDURE NAME CPT Code Review New with Epic Name (Orderables) (Orderables) (Chargeables) HUMERUS/ELBOW CT Humerus Left without Contrast 73200 CT Humerus Right without Contrast 73200 CT Humerus Bilateral without Contrast 73200-50 CT Humerus Left with Contrast 73201 CT Humerus Right with Contrast 73201 CT Humerus Bilateral with Contrast 73201-50 CT Elbow Left without Contrast 73200 CT Elbow Right without Contrast 73200 CT Elbow Bilateral without Contrast 73200-50 CT Elbow Left with Contrast 73201 CT Elbow Right with Contrast 73201 CT Elbow Bilateral with Contrast 73201-50 NCH Radiology Procedure Name List CT Effective November 5, 2016 CURRENT EPIC PROCEDURE NAME CPT Code Review New with Epic Name (Orderables) (Orderables) (Chargeables) FOREARM/WRIST/HAND CT Forearm Left without Contrast 73200 CT Forearm Right without Contrast 73200 CT Forearm Bilateral without Contrast 73200-50 CT Forearm Left with Contrast 73201 CT Forearm Right with Contrast 73201 CT Forearm Bilateral with Contrast 73201-50 CT Wrist Left without Contrast 73200 CT Wrist Right without Contrast 73200 CT Wrist Bilateral without Contrast 73200-50 CT Wrist Bilateral Dynamic without Contrast 73200 NCH Radiology Procedure Name List CT Effective November 5, 2016 CURRENT EPIC PROCEDURE NAME CPT Code Review New with Epic Name (Orderables) (Orderables) (Chargeables) CT Wrist Left with Contrast 73201 CT Wrist Right with Contrast 73201 CT Wrist Bilateral with Contrast 73201-50 CT Hand Left without Contrast 73200 CT Hand Right without Contrast 73200 CT Hand Bilateral without Contrast 73200-50 CT Hand Left with Contrast 73201 CT Hand Right with Contrast 73201 CT Hand Bilateral with Contrast 73201-50 NCH Radiology Procedure Name List CT Effective November 5, 2016 CURRENT EPIC PROCEDURE NAME CPT Code Review New with Epic Name (Orderables) (Orderables) (Chargeables) LOWER EXT CT Lower Extremity Angiography Left with Contrast 73706 CT Lower Extremity Angiography Right with Contrast 73706 CT Lower Extremity Angiography Bilateral with Contrast 73706-50 THIGH/KNEE CT Thigh Left without Contrast 73700 CT Thigh Right without Contrast 73700 CT Thigh Bilateral without Contrast 73700-50 CT Knee Left without Contrast 73700 CT Knee Right without Contrast 73700 CT Knee Bilateral without Contrast 73700-50 CT Thigh Left with Contrast 73701 CT Thigh Right with Contrast 73701 NCH Radiology Procedure Name List CT Effective November 5, 2016 CURRENT EPIC PROCEDURE NAME CPT Code Review New with Epic Name (Orderables) (Orderables) (Chargeables) CT Thigh Bilateral with Contrast 73701-50 CT Knee Left with Contrast 73701 CT Knee Right with Contrast 73701 CT Knee Bilateral with Contrast 73701-50 ANKLE/FOOT CT Ankle Left without Contrast 73700 CT Ankle Right without Contrast 73700 CT Ankle Bilateral without Contrast 73700-50 CT Ankle Left with Contrast 73701 CT Ankle Right with Contrast 73701 CT Ankle Bilateral with Contrast 73701-50 CT Foot Left without Contrast 73700 CT Foot Right without Contrast 73700 NCH Radiology Procedure Name List CT Effective November 5, 2016 CURRENT EPIC PROCEDURE NAME CPT Code Review New with Epic Name (Orderables) (Orderables) (Chargeables) CT Foot Bilateral without Contrast 73700-50 CT Foot Left with Contrast 73701 CT Foot Right with Contrast 73701 CT Foot Bilateral with Contrast 73701-50 ABDOMEN Abdomen NO CONTRAST - CT CT Abdomen without Contrast 74150 Abdomen IV ONLY - CT CT Abdomen with IV Contrast 74160 Abdomen ORAL ONLY - CT CT Abdomen Oral Contrast Only 74150 Abdomen ORAL-IV - CT CT Abdomen with IV and Oral Contrast 74160 Abdomen DUAL - CT CT Abdomen without then with Contrast 74170 CT Angiography ABDOMEN CT Abdomen Angiography with Contrast 74175 CT Angiography RENAL ARTERIES CT Abdomen Angiography Renal with Contrast 74175 CT Abdomen Angiography Liver with Contrast 74175 NCH Radiology Procedure Name List CT Effective November 5, 2016 CURRENT EPIC PROCEDURE NAME CPT Code Review New with Epic Name (Orderables) (Orderables) (Chargeables) ABD-PELVIS Abdomen-PELVIS IV AND ORAL CONTRAST - CT CT Abdomen Pelvis without Contrast 74176 Abdomen-PELVIS NO CONTRAST CT CT Abdomen Pelvis Urinary Calculus without Contrast 74176 CT Abdomen Pelvis with IV Contrast 74177 Abdomen-PELVIS ORAL ONLY - CT CT Abdomen Pelvis Oral Contrast Only 74176 CT Abdomen Pelvis without then with Contrast 74178 CT Abdomen Pelvis Angiography with Contrast 74174 OTHER FLUID DRAINAGE - CT CT Fluid Drainage with Cath Placement 75989 CT CONSULTATION WITH REPORT CT Consult with Report Neuro 76140 BIOPSY - CT CT Biopsy with Needle 77012 76377 COMPUTER RECONSTRUCTIONS - CT CT Computer Reconstructions 76376 GUIDED TISSUE ABLATION CT CT Guided Ablation Soft Tissue 77013 CT Guided Ablation Bone 76380 NCH Radiology Procedure Name List CT Effective November 5, 2016 CURRENT EPIC PROCEDURE NAME CPT Code Review New with
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