Commonly Used CPT Codes for CT (Computed Tomography) Harrison Imaging Centers Procedure CPT Code Indications CT Abdomen Pelvis with and 74178 IVP, Hematuria-Kidneys, Ureter, Bladder without IV Contrast CT Abdomen Pelvis with IV 74177 Emergent Appendicitis Contrast CT Abdomen Pelvis without 74176 KUB Renal Colic - Kidney Stones, Ureters, Bladder IV Contrast CT Abdomen with and 74170 Pancreas, Liver, Adrenal without IV Contrast CT Angiogram Abdomen CT Angiography - Aorta, Bifurcation, Mesenteric, Pelvis with and or without IV 74174 Internal/Ext Iliac Arteries, Aneurysm, Dissection Contrast CT Angiogram Abdomen CT Angiography- Visualization of Abdominal Aorta, 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/Breast 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, Neck Pain, Degenerative Disc 72125 Contrast Disease , HNP CT Chest High Resolution 71250 Follow up on Pulmonary Nodule Most common, Lung, 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, Osteomyelitis. Limit scan area to area of Contrast interest *Not CT Angiogram Trauma, Fracture, Bone 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 Back Pain, Degenerative 72131 Contrast Disc Disease , HNP CT Maxillofacial without IV 70486 Trauma, Fracture Contrast Evaluate organs of the Pelvis- Bladder, Ovaries, Uterus, 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 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 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, Stroke 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 Ankle with and without IV Inflammation, Infection, Osteomyelitis, Tumor, 73723 Contrast Mass Most Common. Ligament/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 Elbow 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 Foot 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 Hip with and without IV Inflammation, Infection, Osteomyelitis, 73723 Contrast Tumor, Mass MRI Hip with IV Contrast 73722 Arthrogram – Tear, Ligament Injury, Surgery MRI Knee 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 Face 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 Shoulder 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 - Rotator cuff Tear, Ligament or 73221 Contrast Tendon Tear, Trauma, FX, Avascular Necrosis MRI Temporomandibular 70336 TMJ, Dental Joints 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 Wrist with and without