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Commonly Used CPT Codes for CT (Computed )

Harrison Imaging Centers

Procedure CPT Code Indications

CT with and 74178 IVP, Hematuria-Kidneys, , Bladder without IV Contrast

CT Abdomen Pelvis with IV 74177 Emergent Appendicitis Contrast

CT Abdomen Pelvis without 74176 KUB Renal Colic - Kidney Stones, , Bladder IV Contrast

CT Abdomen with and 74170 Pancreas, Liver, Adrenal without IV Contrast

CT Angiogram Abdomen CT - , Bifurcation, Mesenteric, Pelvis with and or without IV 74174 Internal/Ext Iliac , Aneurysm, Dissection Contrast

CT Angiogram Abdomen CT Angiography- Visualization of , with and or without IV 74175 Splenic, Celiac and Renal Arteries Contrast

CT Angiogram Abdominal Aorta and Iliofemoral Runoff CT Angiography. Visualization Abdominal , Pelvic 75635 with and or without IV and Bilateral Lower Extremity Arteries Contrast

CT Angiogram Chest 71275 Abdomen Pelvis with and Combined CT Angiogram Chest/Abdomen/Pelvis 72174 without IV Contrast

CT Chest Angiography- Visualization Chest Great CT Angiogram Chest with Vessels, Pulmonary Arteries, Thoracic Aorta. 71275 and without IV Contrast Pulmonary Embolism, Aneurysm, Dissection, Widen Mediastinum

Commonly Used CPT Codes for CT | Harrison Imaging Centers Silverdale/Port Orchard/ Imaging: (360) 377-6500 Bremerton/Poulsbo: (360) 479-6555

Procedure CPT Code Indications

CT Cervical Spine with IV 72126 Abscess , Infection, Discitis Contrast

CT Cervical Spine without IV Trauma, Fracture, Pain, Degenerative Disc 72125 Contrast Disease , HNP

CT Chest High Resolution 71250 Follow up on Pulmonary Nodule

Most common, , Chest Mass, Nodule, Tumor, CT Chest with IV Contrast 71260 Pneumonia, Abscess, abnormal Chest X-ray, SOB, Chest Pain

CT Chest without IV Contrast 71250 Follow up on Pulmonary Nodule

CT Enterography Abdomen 74177 Bowel Disease, Crohn’s Disease and Pelvis with IV Contrast

Tumor or Mass, Metastatic Disease, Abscess, CT Head with IV Contrast 70460 Infection, Follow-up

Most common, Acute Headaches , Trauma Bony CT Head without IV Contrast 70450 Abnormality, Fracture, Dizziness, CVA, TIA, Dementia, Altered Mental Status (AMS)

CT Heart Calcium Score 75571 Calcium Score Quantification without IV Contrast

CT Landmark Sinus without 70486 Pre-Surgical Scan- Sinus IV Contrast

Commonly Used CPT Codes for CT | Harrison Imaging Centers Silverdale/Port Orchard/Breast Imaging: (360) 377-6500 Bremerton/Poulsbo: (360) 479-6555

Procedure Name CPT Code Indications

Soft Tissue, Mass, Tumor, Cellulites, Abscess. CT Lower Extremity with IV 73701 Infection, . Limit scan area to area of Contrast interest *Not CT Angiogram

Trauma, Fracture, Detail, Erosion, Post Op CT Lower Extremity without 73700 Fracture Status, Non-Union Limit scan area to area IV Contrast of interest

CT Lumbar Spine with IV 72132 After myelogram, Abscess, Infection, Discitis Contrast

CT Lumbar Spine without IV Trauma, Fracture, Low Pain, Degenerative 72131 Contrast Disc Disease , HNP

CT Maxillofacial without IV 70486 Trauma, Fracture Contrast Evaluate organs of the Pelvis- Bladder, Ovaries, , Prostate. LLQ or RLQ Pain, Mass, Pelvic CT Pelvis with IV Contrast 72193 Tumor, Inguinal Hernia, Abscess *Not usually ordered without CT Abdomen.

Evaluate Bony structures of the Pelvis-Trauma, CT Pelvis without IV Contrast 72192 Fracture, Lesions

Soft Tissue Structures, Thyroid, Lymph Nodes, CT Soft Tissue Neck with IV Larynx, Salivary Glands- Tumor or Mass, Difficulty 70491 Contrast Swallowing, Enlarged Lymph Nodes, Lymphoma, Abscess Commonly Used CPT Codes for CT | Harrison Imaging Centers Silverdale/Port Orchard/Breast Imaging: (360) 377-6500 Bremerton/Poulsbo: (360) 479-6555

Epic Procedure Name CPT Code Indications

CT Thoracic Spine with IV 72129 After myelogram, Abscess, Infection, Discitis Contrast

CT Thoracic Spine without IV Trauma, Fracture, Mid Back Pain, Degenerative 72128 Contrast Disc Disease , HNP

Soft Tissue, Mass, Tumor, Cellulites, Abscess, CT Upper Extremity with IV 73201 Infection, Osteomyelitis. Limit scan area to area of Contrast interest only *Not CT Angiogram

Trauma, Fracture, Bone Detail, Erosion. Post Op CT Upper Extremity without 73200 Fracture status, Non-Union Limit scan area to area IV Contrast of interest only

Indications and exams provided as a general guideline. Should you have questions about exam appropriateness, consult a radiologist or the ACR Appropriateness Criteria®.

ACR Appropriateness Criteria® 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. By employing these guidelines, providers enhance quality of care and contribute to the most efficacious use of . http://www.acr.org/SecondaryMainMenuCategories/quality_safety/app_criteria.aspx

For patients requiring IV contrast for either CT or MRI: Recent (30 days) creatinine and BUN lab results will be requested for patients over age 60 or with a history of kidney disease, hypertension and/or diabetes.

Commonly Used CPT Codes for CT | Harrison Imaging Centers Silverdale/Port Orchard/Breast Imaging: (360) 377-6500 Bremerton/Poulsbo: (360) 479-6555

Commonly Used CPT Codes for MRI

Harrison Imaging Centers

Procedure CPT Code Indications

MRI Abdomen with and Liver, Spleen, Kidneys, Adrenal glands, Pancreas, 74183 without IV Contrast Tumor, Mass, Cysts

MRI Abdomen without IV Evaluate Gallbladder, Common Bile Duct, 74181 Contrast Pancreatic Duct, Stones

MR Angiogram-Abdominal Aorta to include MRI Angiogram Abdomen with 74185 bifurcation-Renal, Celiac, Super/Inferior and without IV Contrast Mesenteric Arteries MRI Angiogram Chest with and 71555 MR Angiogram- Great Vessels without IV Contrast MRI Angiogram Head with and 70546 MR Angiogram- Brain, Aneurysm, without IV Contrast MR Angiogram -Carotid, Subclavian and MRI Angiogram Neck with and 70549 Vertebral Arteries-Include Aortic Arch to Circle without IV Contrast of Willis

MRI with and without IV Inflammation, Infection, Osteomyelitis, Tumor, 73723 Contrast Mass

Most Common. /Tendon Tears, MRI Ankle without IV Contrast 73721 Avascular Necrosis, Trauma, FX

MRI Brachial Plexus 71552 Chest Mass, Tumor

MRI Brain with and without IV 70553 MS, Cancer History, IAC Contrast

MRI Brain without IV Contrast 70551 Routine, Headache

MRI Breast with and without 77059 New Cancer Diagnosis, History IV Contrast

Commonly Used CPT Codes for MRI | Harrison Imaging Centers Silverdale/Port Orchard/Breast Imaging: (360) 377-6500 Bremerton/Poulsbo: (360) 479-6555

Procedure CPT Code Indications

MRI Cervical Spine with and 72156 MS, Cancer History, Cord lesion, Discitis without IV Contrast

MRI Cervical Spine without IV Most Common - Neck Pain, Suspected HNP, 72141 Contrast Trauma

MRI with and without IV Inflammation, Infection, Osteomyelitis, 73223 Contrast Tumor, Mass

MRI Elbow with IV Contrast 73222 Arthrogram – Tear, Ligament Injury, Surgery

Most Common - Ligament or Tendon Tear, MRI Elbow without IV Contrast 73221 Trauma, FX, Avascular Necrosis

MRI with and without IV Inflammation, Infection, Osteomyelitis, 73720 Contrast Tumor, Mass

Most Common - Ligament or tendon Tear, MRI Foot without IV Contrast 73718 Trauma, FX

MRI with and without IV Inflammation, Infection, Osteomyelitis, 73723 Contrast Tumor, Mass

MRI Hip with IV Contrast 73722 Arthrogram – Tear, Ligament Injury, Surgery

MRI with and without IV Inflammation, Infection, Osteomyelitis, 73723 Contrast Tumor, Mass

MRI Knee with IV Contrast 73722 Arthrogram – Tear, Ligament Injury, Surgery

Most Common - Ligament/Tendon Tears, MRI Knee without IV Contrast 73721 Meniscal Tears, Avascular Necrosis, Trauma, FX

Commonly Used CPT Codes for MRI | Harrison Imaging Centers Silverdale/Port Orchard/Breast Imaging: (360) 377-6500 Bremerton/Poulsbo: (360) 479-6555

Procedure CPT Code Indications

MRI Lumbar Spine with and MS, Cancer History, Cord Lesion, Discitis, Tumor, 72158 without IV Contrast Post-operative

MRI Lumbar Spine without IV Most Common - Back Pain, Suspected HNP, 72148 Contrast Trauma

Evaluate Gallbladder, Common Bile duct, MRI MRCP without IV Contrast 74181 Pancreatic Duct, Stones

MRI Orbit and or Neck Inflammation, Infection, Osteomyelitis, 70543 with and without IV Contrast Tumor, Mass

MRI Orbit Face and or Neck 70540 Larynx, Lymph Nodes without IV Contrast

MRI Pelvis with and without IV Inflammation, Infection, Osteomyelitis, 72197 Contrast Pelvic organs- Uterus, Bladder, Prostate, Ovaries

MRI Pelvis without IV Contrast 72195 Bony Pelvis, Uterus, Defecogram

MRI Prostate with and without Prostate Specific Protocol 72197 IV Contrast *Schedule at Bremerton Prostate Coil only

MRI with and Inflammation, Infection, Osteomyelitis, 73223 without IV Contrast Tumor, Mass

MRI Shoulder with IV Contrast 73222 Arthrogram – Tear, Ligament Injury, Surgery

MRI Shoulder without IV Most Common - , Ligament or 73221 Contrast Tendon Tear, Trauma, FX, Avascular Necrosis

MRI Temporomandibular 70336 TMJ, Dental

Commonly Used CPT Codes for MRI | Harrison Imaging Centers Silverdale/Port Orchard/Breast Imaging: (360) 377-6500 Bremerton/Poulsbo: (360) 479-6555

Commonly Used CPT Codes for MRI

Harrison Imaging Centers

Procedure CPT Code Indications

MRI Thoracic Spine with and MS, Cancer History, Spinal Surgery History, 72157 without IV Contrast Discitis

MRI Thoracic Spine without IV Most Common - Mid Back Pain, Suspected HNP, 72146 Contrast Trauma

MRI with and without IV Inflammation, Infection, Osteomyelitis, 73223 Contrast tumor, Mass

MRI Wrist with IV Contrast 73222 Arthrogram – Tear, Ligament Injury, Surgery

Most Common - Ligament or Tendon Tear, MRI Wrist without IV Contrast 73221 Trauma, FX, Avascular Necrosis

Indications and exams provided as a general guideline. Should you have questions about exam appropriateness, consult a radiologist or the ACR Appropriateness Criteria®.

ACR Appropriateness Criteria® 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. By employing these guidelines, providers enhance quality of care and contribute to the most efficacious use of radiology. http://www.acr.org/SecondaryMainMenuCategories/quality_safety/app_criteria.aspx

For patients requiring IV contrast for either CT or MRI: Recent (30 days) creatinine and BUN lab results will be requested for patients over age 60 or with a history of kidney disease, hypertension and/or diabetes.

Commonly Used CPT Codes for MRI | Harrison Imaging Centers Silverdale/Port Orchard/Breast Imaging: (360) 377-6500 Bremerton/Poulsbo: (360) 479-6555 Commonly Used CPT Codes for

Harrison Imaging Centers

Procedure CPT Code Indications

Abdominal Pain, Nausea and/or Vomiting, US Abdomen Complete 76700 Abnormal Liver Function Test

Specific or Region - Hernia, Pyloric Stenosis, US Abdomen Limited 76705 , RUQ, Evaluation , Gallstones, Hepatitis

US Abdominal Aorta Limited 76775 Diagnostic Aorta Evaluation

US Breast Biopsy Initial 19083 Mass, Lesion Lesion

US Breast Complete 76641 Screening - Complete Breast and

US Breast Limited 76642 Diagnostic - Specific Targeted Area

US Chest 76604 Pleural Effusion, Mass

US Extremity Non Vascular Pain, Tendon/Ligament Pain, Fluid Collection, 76882 Limited Mass

US Fetal Biophysical Profile Biophysical Profile Only. Add OB Limited if 76819 without Non Stress Testing Additional Needed

Uterine Abnormalities, , Multiple US Hysterosonogram 76831 Miscarriage

US Infant with Dysplasia, , Hip Click, Family History of 76885 Manipulation DDH

Commonly Used CPT Codes for Ultrasound | Harrison Imaging Centers Silverdale/Port Orchard/Breast Imaging: (360) 377-6500 Bremerton/Poulsbo: (360) 479-6555

Procedure CPT Code Indications

US Medicare AAA Screen G0389 Medicare Abdominal Aorta Screening

US OB Detail Fetal 76811 Fetal Survey Only, Gestational Age of 18-20 Weeks Single or First Gestation

Cervical Length, Pre-Term Labor, Cramping, US OB Greater than 14 76805 Spotting, History of Cervical Incompetence, Weeks and OB Transvaginal Placenta Previa or Placenta Location

US OB Less than 14 Weeks Early OB study with Transvaginal to Visualize Single or First Gestation and 76801 Anatomy OB Transvaginal US OB Less than 14 Weeks Transabdominal Single 76801 Early OB study, no TV Gestation

US OB Limited 76815 AFI, HR, Placenta or

AFI, HR, Placenta or Position with Transvaginal US OB Transvaginal 76817 Imaging to Visualize Anatomy

US Pelvis Complete Pain, , 76856 (Transabdominal Only) Fibroid Uterus, Post-Menopausal Bleeding

Pain, Ovarian Cyst, Ovarian Torsion US Pelvis Complete and US 76856 Fibroid Uterus, Post-Menopausal Bleeding, with TV Non-OB Transvaginal to Visualize Anatomy

Urinary Retention, Post Void Residual, Enlarged US Pelvis Limited 76857 Prostate, Bladder Outlet Obstruction

Commonly Used CPT Codes for Ultrasound | Harrison Imaging Centers Silverdale/Port Orchard/Breast Imaging: (360) 377-6500 Bremerton/Poulsbo: (360) 479-6555

Procedure CPT Code Indications

US Retroperitoneal Kidney Stone, Hematuria, ARF, CRI, Follow-up 76770 Complete Hydronephrosis

Flank Pain, Renal Failure, Trauma, Hydronephrosis, US Retroperitoneal Limited 76775 Renal Stone

US Scrotum and 76870 Pain, Mass, Torsion

US Thyroid Parathyroid Mass, Enlarged Thyroid or Parathyroid, Hyper- or 76536 Neck Hypothyroidism, History of Thyroid Cancer

Vascular AAA Duplex 93979 Diagnostic Aorta Evaluation Limited

Vascular Arterial Lower 93925 Aneurysm, Arterial Embolus, Graft Evaluation Extremity Duplex Bilateral

Vascular Arterial Lower 93926 Aneurysm, Arterial Embolus, Graft Evaluation Extremity Duplex

Vascular Carotid Duplex Syncope, Hemiplegia, Difference in Blood 93880 Bilateral Pressure, Aphasia, Ataxia

Vascular Inferior Vena Cava 93979 Duplex Limited

Vascular Portal Hepatic Cirrhosis or Hepatic Disease, Ascites, Varices, Portal 93976 Venous Duplex Limited Thrombosis

Commonly Used CPT Codes for Ultrasound | Harrison Imaging Centers Silverdale/Port Orchard/Breast Imaging: (360) 377-6500 Bremerton/Poulsbo: (360) 479-6555

Procedure CPT Code Indications

Vascular Renal Duplex Renal Stenosis, Uncontrolled Hypertension, 93975 Bilateral Renal Bruit, Stent Follow-Up

Vascular Lower 93970 DVT, Postphlebetic Ulcer, Varicose Veins with Pain Extremity Duplex Bilateral

Vascular Veins Lower 93971 DVT, Postphlebetic Ulcer, Varicose Veins with Pain Extremity Duplex

Indications and exams provided as a general guideline. Should you have questions about exam appropriateness, consult a radiologist or the ACR Appropriateness Criteria®.

ACR Appropriateness Criteria® 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. By employing these guidelines, providers enhance quality of care and contribute to the most efficacious use of radiology. http://www.acr.org/SecondaryMainMenuCategories/quality_safety/app_criteria.aspx

Commonly Used CPT Codes for Ultrasound | Harrison Imaging Centers Silverdale/Port Orchard/Breast Imaging: (360) 377-6500 Bremerton/Poulsbo: (360) 479-6555