Quick Reference Guide

Exam Common Reasons for Ordering Prep CPT Code

\Whole Body Bone History of CA, , trauma No Prep 78306 addl. MDP A9503 Three Phase Bone Cellulitis vs. , RSD, AVN No Prep 78315 addl. MDP A9503 Bone SPECT Low back pain, evaluate for PARS Fx No Prep 78320 addl. MDP A9503 HIDA w/CCK Acute vs. chronic cholecystitis, biliary tract NPO 4 Hours 78227 addl. obstruction, bile leaks, Gallbladder Dyskinesia No pain meds CHOLETEC 6 hours prior A9537 Meckels Detect and localize Meckels diverticulum NPO 4 hours prior 78290 addl. containing functioning gastric mucosa No recent barium STRAIGHT studies TECH A9512 /Spleen Scan Assess chronic liver disease, Assess liver and 78215 addl. spleen size and configuration, detect assessor No Prep SULFUR splenic tissue COLLOID A9541 Liver Spect for Hemangioma Assess liver hemangioma No prep 78206 addl. ULTRATAG A9560 I 123 Thyroid w/Uptake/scan Evaluate hyperthyroidism, evaluate enlarged Off antithyroid meds 78014 addl. glands or glands with nodules, diagnose graves 7 days before IODIDE disease, evaluate sub-acute and chronic thyroiditis (methimazole, Capsule carbimazole, A9516 propylthiouracil) Off thyroid hormones - 2 weeks triiodothyronine - 4 weeks thyroxine No Radiographic contrast 4 weeks prior No Amiodarone - 1 month prior Parathyroid w/Spect Detect and localize parathyroid adenomas Obtain lab results 78071 addl. (serum calcium levels, CARDIOLITE parathyroid hormone A9500 and urinary excretion of calcium) Renal Scan w/Lasix Evaluation of renal perfusion and function 78708 addl. Evaluation and detection of renal collecting No prep MAG 3 system obstruction A9562 Renal Scan w/MAG 3 Evaluation of renal perfusion and function 78707 addl. Evaluation and detection of renal collecting No prep MAG 3 system obstructio A9562 Renal Scan w/Captopril Evaluation of renal artery stenosis and function No prep (If patient is 78708 addl. Evaluation and detection of renal collecting on BP medication they MAG 3 system obstruction should stop 24 hrs. A9562 prior to test) MUGA Planar Evaluate ventricular wall motion. Ventricular 78472 addl. ejection fraction. Differentiate pulmonary and No Prep ULTRATAG cardiac causes of dyspnea. Monitor cardio A9560 toxicity of doxorubicin. Nuclear Medicine Quick Reference Guide

Exam Common Reasons for Ordering Prep CPT Code

Octreo Scan Whole Detection and localization of neuroendocrine Stop octreotide therapy 78804 addl. Body and Spect tumors: Carcinoid Tumors, Insulinomas, 2 days prior to study. OCTREO Paragangliomas, Gastrinomas, Extended release A9572 Pheochromocytomas, Neuroblastomas, Octreotide is given Glucagonomas, small cell CA, as injection 1 month. medullary thyroid CA These patients should Detection and localization of neuroendocrine have procedure tumors: Carcinoid Tumors, Insulinomas, scheduled 2 days Paragangliomas, Gastrinomas, prior to injection. Pheochromocytomas, Neuroblastomas, Glucagonomas, small cell lung CA, medullary thyroid CA Detection and localization of meningiomas Selection of patients w/ carcinoid tumors who are likely to benefit from octreotide therapy Exercise Stress/Rest Detection of coronary artery disease NPO 4 hours 78452 addl. Myocardial Perfusion Scan Risk stratification of coronary artery disease before test THALLIUM Evaluation of chest pain Avoid beta blockers A9505 24 hrs prior to test Avoid caffeine 12 hrs before test Drug Induced Stress/ Detection of coronary artery disease All drug induced stress 78452 addl. Rest Myocardial Risk stratification of coronary artery disease tests must be NPO 4 ADENOSINE Perfusion Scan Evaluation of chest pain hours before test J0152 Used as alternative to exercise stress test in Regadenoson/ patients who cannot exercise adequately Persantine Prep: Avoid caffeine and nicotine 18-24 hrs before test Pt off of meds containing theophylline 48-72 hrs before test Pt off Aggrenox or any diprydamole medications for at least 48 hrs before test Pt may be on beta blockers Non theophylline inhalers are allowed before the test Dobutamine Prep: Pt must be off beta blockers 24 hrs prior to test Pt may take meds containing theophylline Nuclear Medicine Quick Reference Guide

Exam Common Reasons for Ordering Prep CPT Code

Datscan Detection of Parkinson’s Disease List of meds needs to 78607 addl. be withheld DATSCAN Ephedrine, Ketamine A9584 Isoflurane (1 day) Cocaine, Methylphenidate (2 days) Methamphetamine, Mazindol, Modafinil (3 days) Benzotropine, Fentanyl (5 days) Dexamphetamine (7 days) Bupropion (8 days) Phentermine, Phencyclidine (14 days) Scan-Whole Body Detection of swelling, inflammation, No prep 78800 addl. in the body GALLIUM (Eat Lightly after injection) A9556 Pet/CT Bone (Prostate CA) Detection/Assessment of Bone Metastasis No prep 78816 in patients with Pet/CT Bone AXUMIN Specific to patients who are post Prostate NPO 6 hours 78815 addl. Cancer treatment (surgery, radiation etc.) No exercise for AXUMIN and have a rising PSA 24 hours A9588 Pet/CT Full Body Detection of melanoma, multiple myeloma, and monoclonal gammopathy NPO 4 hours 78816 Pet/CT Skull to Mid Thigh Detection of cancer in the body NPO 4 hours 78815 Pet/CT Brain Detection of disease or injury to the brain NPO 4 hours 78608