cpt® & ICD-9 2015
The following codes are being provided as a quick reference guide only. Please be sure to consult your office
AMA CPT code book to confirm all codes.
Breast Procedures
CPT Code
CTA
CPT Code
US GUIDED BREAST BIOPSY
+ EACH ADDITIONAL LESION (USE WITH 19083)
BREAST CYST ASPIRATION
+ EACH ADDITIONAL CYST (USE WITH 19000)
ULTRASOUND GUIDED FNA x # OF LESIONS
US PLACEMENT OF LOCALIZATION DEVICE
PLACEMENT OF CLIP, METALLIC PELLET, WIRE/NEEDLE, RADIOACTIVE SEEDS
+ EACH ADDITIONAL LESION (USE WITH 19285)
STEREOTACTIC GUIDED BIOPSY
+ EACH ADDITIONAL LESION (USE WITH 19081)
BREAST CYST ASPIRATION
+ EACH ADDITIONAL CYST (USE WITH 19000)
STEREOTACTIC PLACEMENT OF LOCALIZATION WIRE
PLACEMENT OF CLIP, METALLIC PELLET, WIRE/NEEDLE, RADIOACTIVE SEEDS
+ EACH ADDITIONAL LESION (USE WITH 19283)
MR GUIDED BREAST BIOPSY
+ EACH ADDITIONAL LESION (USE WITH 19085)
BREAST CYST ASPIRATION
+ EACH ADDITIONAL CYST (USE WITH 19000)
MR PLACEMENT OF LOCALIZATION DEVICE
PLACEMENT OF CLIP, METALLIC PELLET, WIRE/NEEDLE, RADIOACTIVE SEEDS
+ EACH ADDITIONAL LESION (USE WITH 19287)
CT GUIDED BIOPSY
BREAST BIOPSY PER LESION
BREAST CYST ASPIRATION
+ EACH ADDITIONAL CYST (USE WITH 19000)
MAMMOGRAPHIC GUIDED BIOPSY
BREAST CYST ASPIRATION
MAMMOGRAPHIC PLACEMENT OF LOCALIZATION WIRE
PLACEMENT OF CLIP, METALLIC PELLET, WIRE/NEEDLE, RADIOACTIVE SEEDS
+ EACH ADDITIONAL LESION (USE WITH 19281)
POST BIOPSY MAMMOGRAM
BILATERAL
UNILATERAL
MAMMOGRAPHY
DIAGNOSTIC BILATERAL TOMOSYNTHESIS
DIAGNOSTIC UNILATERAL TOMOSYNTHESIS
DIGITAL DIAGNOSTIC BILATERAL
DIGITAL DIAGNOSTIC UNILATERAL
DIGITAL SCREENING BILATERAL
DIGITAL SCREENING BILATERAL WITH TOMOSYNTHESIS
DIGITAL SCREENING UNILATERAL
DUCTOGRAM MULTI DUCT
DUCTOGRAM SINGLE DUCT
19083
19084
76942, 19000
19001
76942, 10022
ABDOMEN ABDOMEN/PELVIS RUN-­‐OFF STUDY (ABDOMINAL AORTA & BILATERAL LWR EXTREMITIES)
CHEST (NONCORONARY)
CORONARY ARTERIES
HEAD LOWER EXTREMITY NECK (CAROTID)
PELVIS UPPER EXTREMITY MYELOGRAM
CERVICAL SPINE
74175
74174
75635
71275
75574
70496
73706
70498
72191
73206
CERVICAL C-­‐1-­‐C2
62302, 72126
THORACIC SPINE
62303, 72129 LUMBAR
62304, 72132 2 OR MORE REGIONS (EG, LUMBAR/THORACIC,
THORACIC/CERVICAL, LUMBAR/CERVICAL)
POSTERIOR FOSSA
2 CT Codes based on region
SURGICAL SPECIMEN
ULTRASOUND
BREAST(S)
MRI
BREAST UNILATERAL
BREASTS BILATERAL
76098
19285
19286
19081
19082
77031, 19000
19001
62302, 72126
19283
19284
19085
19086
77021, 19000
19001
19287
CISTERNOGRAPHY
19288
77012, 19499
77012, 19000
19001
77032, 19000, 19001
19281
19282
G0204, 77051
G0206, 77051
77062
77061
G0204, 77051
G0206, 77051
G0202, 77052
G0202, 77052, 77063
G0202-­‐52, 77052
19030, 77054
19030, 77053
76641 or 76642
77058
77059
ARTHROGRAM -­‐ Conventional (RAD) w CT
ELBOW
HIP
SHOULDER
KNEE
WRIST
WRIST 3 JOINT
ANKLE
SACROILIAC (SI) JOINT TMJ
ARTHROGRAM -­‐ Non -­‐ Conventional w CT
ELBOW
HIP
SHOULDER
KNEE
WRIST
WRIST 3 JOINT
ANKLE
SACROILIAC (SI) JOINT TMJ
NEEDLE GUIDED BIOPSY
LIVER
LYMPH NODES
THIGH
KIDNEY -­‐ RENAL MASS
SOFT TISSUE MASS
UNLISTED CT PROCEDURE
62305 &
70460, 70010, 77003 &
61055 or 62284
70460, 70015, 77003 &
61055 or 62284
73201, 24220, 73085
73701, 27093, 73525
73201, 23350, 73040
73701, 27370, 73580
73201, 25246, 73115
73201, 25246,73115
73701, 27648, 73615
27096, 72193
70487, 21116, 70332
73201, 24220, 77002
73701, 27093, 77002
73201, 23350, 77002
73701, 27370, 77002
73201, 25246, 77002
73201, 25246, 77002
73701, 27648, 77002
27096, 72193
21116, 70487, 77002
47000, 77012
38505, 77012
20206, 77012
50200, 77012
20206, 77012
76497
CT
CPT Code
CT
CPT Code
3D RECONSTRUCITON W/O POSTPROCESSING
3D RECONSTRUCTION WITH POSPROCESSING
ABDOMEN/PELVIS WITHOUT CONTRAST
ABDOMEN/PELVIS WITH CONTRAST
ABDOMEN/PELVIS W-­‐W/O CONTRAST
ABDOMEN WITHOUT CONTRAST
ABDOMEN WITH CONTRAST
ABDOMEN W-­‐W/O CONTRAST
BRAIN WITHOUT CONTRAST
BRAIN WITH CONTRAST
BRAIN W-­‐W/O CONTRAST
CARDIAC CALCIUM SCORING WITHOUT CONTRAST
CARDIAC STRUCTURE AND MORPHOLOGY W/ CONTRAST
CARDIAC STRUCTURE AND MORPHOLOGY -­‐ IN THE SETTING
76376
76377
74176
74177
74178
74150
74160
74170
70450
70460
70470
75571
75572
75573
LUMBAR SPINE WITHOUT CONTRAST
LUMBAR SPINE WITH CONTRAST
LUMBAR SPINE W-­‐W/O CONTRAST
LUNG SCREENING
LOWER EXTREMITY WITHOUT CONTRAST
LOWER EXTREMITY WITH CONTRAST
LOWER EXTREMITY W-­‐W/O CONTRAST
MAXILLOFACIAL WITHOUT CONTRAST
MAXILLOFACIAL WITH CONTRAST
MAXILLOFACIAL W-­‐W/O CONTRAST
NECK SOFT TISSUE WITHOUT CONTRAST
NECK SOFT TISSUE WITH CONTRAST
NECK SOFT TISSUE W-­‐W/OUT CONTRAST
ORBITS WITHOUT CONTRAST
72131
72132
72133
71250
73700
73701
73702
70486
70487
70488
70490
70491
70492
70480
CERVICAL SPINE WITHOUT CONTRAST
CERVICAL SPINE WITH CONTRAST
CERVICAL SPINE W-­‐W/O CONTRAST
CHEST WITHOUT CONTRAST
CHEST WITH CONTRAST
CHEST W-­‐W/OUT CONTRAST
COCCYX WITH CONTRAST
COCCYX WITHOUT CONTRAST
COCCYX W/WO CONTRAST
DENTAL IMPLANTS WO CONT
DENTAL SCAN ONLY
DENTAL SCAN W PROCESS BOTH
DENTAL SCAN WITH PROCESSING
DNTL SCAN ONLY BOTH TOP AND BOTTOM
ELBOW WITHOUT CONTRAST
ELBOW WITH CONTRAST
ELBOW W-­‐W/O CONTRAST
ENTEROGRAPHY (ABD & PEL W CONTRAST)
FACIAL BONES WITHOUT CONTRAST
FACIAL BONES WITH CONTRAST
FACIAL BONES W-­‐W/O CONTRAST
FOLLOW-­‐UP STUDY LIMITED OR LOCALIZED
FOOT-­‐ANKLE WITHOUT CONTRAST
FOOT-­‐ANKLE WITH CONTRAST
FOOT-­‐ANKLE W-­‐W/O CONTRAST
FOREARM WITHOUT CONTRAST
FOREARM WITH CONTRAST
FOREARM W-­‐W/O CONTRAST
HAND WITHOUT CONTRAST
HAND WITH CONTRAST
HAND W-­‐W/O CONTRAST
HIP WITHOUT CONTRAST
HIP WITH CONTRAST
HIP W-­‐W/O CONTRAST
HUMERUS WITHOUT CONTRAST
HUMERUS WITH CONTRAST
HUMERUS W-­‐W/O CONTRAST
IACS, ORBIT, SELLA OR POSTERIOR FOSSA W/O CONTRAST
72125
72126
72127
71250
71260
71270
72193
72192
72194
70486
CASH PAY ONLY
CASH PAY ONLY
CASH PAY ONLY
CASH PAY ONLY
73200
73201
73202
74177, 76376 or 76377
70486
70487
70488
76380
73700
73701
73702
73200
73201
73202
73200
73201
73202
73700
73701
73702
73200
73201
73202
70480
ORBITS WITH CONTRAST
ORBITS W-­‐W/O CONTRAST
PELVIS WITHOUT CONTRAST
PELVIS WITH CONTRAST
PELVIS W-­‐W/O CONTRAST
PITUITARY-­‐SELLA WITHOUT CONTRAST
PITUITARY-­‐SELLA WITH CONTRAST
PITUITARY-­‐SELLA W-­‐W/O CONTRAST
POSTERIOR FOSSA WITHOUT CONTRAST
POSTERIOR FOSSA WITH CONTRAST
POSTERIOR FOSSA W-­‐W/O CONTRAST
SACRUM WITHOUT CONTRAST
SACRUM WITH CONTRAST
SACRUM W-­‐W/O CONTRAST
SCANOGRAM
SHOULDER WITHOUT CONTRAST
SHOULDER WITH CONTRAST
SHOULDER W-­‐W/O CONTRAST
SINUS LTD WITHOUT CONTRAST
SINUS WITHOUT CONTRAST
SINUS WITH CONTRAST
SINUS W-­‐W/O CONTRAST
TEMPORAL BONES WITHOUT CONTRAST
TEMPORAL BONES WITH CONTRAST
TEMPORAL BONES W-­‐W/O CONTRAST
THIGH-­‐FEMUR WITHOUT CONTRAST
THIGH-­‐FEMUR WITH CONTRAST
THIGH-­‐FEMUR W-­‐W/O CONTRAST
THORACIC SPINE -­‐ WITHOUT CONTRAST
THORACIC SPINE -­‐ WITH CONTRAST
THORACIC SPINE -­‐ W-­‐W/O CONTRAST
TIB-­‐FIB WITHOUT CONTRAST
TIB-­‐FIB WITH CONTRAST
TIB-­‐FIB W-­‐W/O CONTRAST
TMJS WITHOUT CONTRAST
TMJS WITH CONTRAST
TMJS W-­‐W/O CONTRAST
UPPER EXTREMITY WITHOUT CONTRAST
UPPER EXTREMITY WITH CONTRAST
70481
70482
72192
72193
72194
70480
70481
70482
70480
70481
70482
72192
72193
72194
77073
73200
73201
73202
70486
70486
70487
70488
70480
70481
70482
73700
73701
73702
72128
72129
72130
73700
73701
73702
70486
70487
70488
73200
73201
IACS, ORBIT, SELLA OR POSTERIOR FOSSA W/ CONTRAST
IACS, ORBIT, SELLA OR POSTERIOR FOSSA
W & W/O CONTRAST
KNEE WITHOUT CONTRAST
KNEE WITH CONTRAST
KNEE W-­‐W/O CONTRAST
KUB ABD/PEL W/O
LARYNX WITHOUT CONTRAST
LARYNX WITH CONTRAST
LARYNX W-­‐W/O CONTRAST
70481
70482
UPPER EXTREMITY W-­‐W/O CONTRAST
UROGRAM (ABD PEL W/WO)
73700
73701
73702
74176
70490
70491
70492
VIRTUAL COLONOSCOPY W/O CONTRAST, DIAGNOSTIC
VIRTUAL COLONOSCOPY WITH CONTRAST, DIAGNOSTIC
VIRTUAL COLONOSCOPY W/O CONTRAST, SCREENING
WRIST WITHOUT CONTRAST
WRIST WITH CONTRAST
WRITST W-­‐W/O CONTRAST
RADIATION THERAPY PLANNING
73202
74178 & 76376 or 76377
74261
74262
74263
73200
73201
73202
77014
OF CONGENITAL HEART DISEASE W/ CONTRAST
Fluoroscopy
CPT Code
Fluoroscopy
CPT Code
FISTULA SINUS TRACT STUDY
FLUORO GUID LOC NEEDLE, SPINE
FLUORO GUIDE BX, INJ, ASP
GUIDED BX, INJ, ASPIRATION
LARGE JOINT (EG, SHOULDER, HIP KNEE)
INTERMEDIATE JOINT (EG, TMJ, WRIST, ELBOW, ANKLE)
SMALL JOINT (EG, FINGERS, TOES)
LOOPOGRAM
INDEPENDENT STUDY
SNIFF TEST
FLUORO UP TO ONE HOUR
FLUORO MORE THAN ONE HOUR
FLUORO EVAL OF EXISTING CENTRAL VENOUS ACCESS DEVICE
LUMBAR PUNCTURE (Diagnostic)
LUMBAR PUNCTURE (Therapeutic)
NOSE TO RECTUM EXAMINATION FOR DETECTION OF FOREIGN BODY -­‐ CHILD
BLOOD PATCH
PROCEDURE UNLISTED
TOMOGRAPHY TO COMPLETE EXAM
GANGLION CYST ASPIRATION INJECTION
INJ SINGLE TENDON SHEATH, LIGAMENT
INJ SINUS TRACT -­‐ SINOGRAM
INJECTION VENOGRAM
SIALOGRAM
PERITONEOGRAM
MYELOGRAM -­‐ Conventional (RAD)
POSTERIOR FOSSA
76080, 20501
77003
77002
77002
20610, 77002
20605, 77002
20600, 77002
74425, 50690
76000
76000
76000
76001
36598, 75820 &
75825 or 75827
62270, 77003
62272, 77003
76010
UGI -­‐ W-­‐W/O DELAYED FILMS, WITHOUT KUB
SMALL BOWEL STUDY
UGI -­‐ DOUBLE CONTRAST, W-­‐W/OUT DELAYED FILMS, W/OUT KUB -­‐ ADULTS
UGI -­‐ DOUBLE CONTRAST, W-­‐W/OUT DELAYED FILMS, W/OUT KUB -­‐ INFANTS/CHILDREN
UGI -­‐ DOUBLE CONTRAST, W-­‐W/OUT DELAYED FILMS W/ KUB -­‐ ADULTS
UGI -­‐ DOUBLE CONTRAST, W-­‐W/OUT DELAYED FILMS, W/ KUB & SMALL BOWEL FOLLOW THROUGH -­‐ INFANTS/CHILDREN
UGI -­‐ DOUBLE CONTRAST, W-­‐W/OUT DELAYED FILMS W/
KUB & SMALL BOWEL FOLLOW THROUHG -­‐ ADULTS
UGI -­‐ W-­‐W/O DELAYED FILMS, WITH KUB
UGI -­‐ W/SMALL BOWEL FOLLOW THROUGH
GYNECOLOGICAL AND OBSTETRICAL
HYSTERSALPINGOGRAM (AKA HSG)
VAGINOGRAM (PERINEOGRAM)
URINARY TRACT
CYSTOGRAPHY
74240
74250
74246
62273, 77003
76496
76100
20612, 77002
20550, 77002
76080, 20501
36005, 75820, 75822
70390, 42550
74190, 49400
CERVICAL MYELOGRAM
70010, 77003 & 61055 or 62284
70015, 77003 &
61055 or 62284
62302
THORACIC MYELOGRAM
62303
LUMBAR MYELOGRAM
62304
MYELOGRAM 2 OR MORE REGIONS
62305
ARTHROGRAM -­‐ Conventional (RAD)
ANKLE
ELBOW
HIP
KNEE
TMJ ARTHROGRAM
WRIST ARTHROGRAM
WRIST ARTHROGRAM 3 JOINT
SACROILIAC (SI) JOINT SHOULDER
73615, 27648
73085, 24220
73525, 27093
73580, 27370
70332, 21116
73115, 25246
73115, 25246 x3
27096
73040, 23350
CISTERNOGRAPHY
74246
74247
74249
74249
74241
74245
74740, 58340
74775
74430 & 51600 or 51605
74400
IVP -­‐ INTRAVENOUS, WITH OR WITHOUT KUB,
WITH OR WITHOUT TOMOGRAPHY
IVP ROUTINE -­‐ DRIP AND/OR BOLUS TECHNIQUE, 18 YEARS 74410
OR UNDER IVP -­‐ DRIP AND/OR BOLUS TECHNIQUE 74415
WITH TOMOGRAPHY (ALWAYS W TOMOS IF 18 +)
LOOPOGRAM (ANTEGRADE PYELOGRAM)
74425, 50690 &
50394 or 50390
NEPHROSTOGRAM
74425, 50390 & 50394 or 50690
RETROGRADE PYELOGRAM
74420
URETHROCYSTOGRAPHY -­‐ RETROGRADE
74450, 51610
URETHROCYSTOGRAPHY -­‐ VOIDING (AKA VCUG)
74455, 51600
MEASUREMENT OF POST-­‐VOID RESIDUAL URINE AND/OR 51798
BLADDER CAPACITY BY US (USE WITH URINARY TRACT CODES IF PERFORMED)
THORACENTESIS/PARACENTESIS
CHEST TUBE EXTENDED USE
32551
PARACENTESIS
49083
THORACENTESIS
32555
THORACENTESIS WITH TUBE
32557
GASTROINTESTINAL TRACT
BE (BARIUM ENEMA)
74270
BE AC (BARIUM ENEMA, DOUBLE CONTRAST W/AIR)
74280
THERAPEUTIC ENEMA 74283
CHOLANGIOGRAM THROUGH EXISTING T-­‐TUBE
74305, 47505
ENTEROCLYSIS SMALL BOWEL
74251, 44500, 74340
PHARYNX AND/OR CERVICAL ESOPHAGUS
74210
BARIUM SWALLOW -­‐ ESOPHAGUS
74220
BARIUM SWALLOW -­‐ ESOPHAGUS -­‐ MODIFIED
74230
FOREIGN BODY REMOVAL -­‐ ESOPHAGEAL
74235 & 43215 or 43247
GB -­‐ CHOLECYSTOGRAPHY, ORAL CONTRAST
74290
GB DD -­‐ CHOLECYSTOGRAPHY, ADDITIONAL OR REPEAT 74291
EXAM OR MULTIPLE DAY EXAM
MRI
CPT Code
MRI
CPT Code
ABDOMEN WITHOUT CONTRAST
ABDOMEN WITH CONTRAST
ABDOMEN W-­‐W/O CONTRAST
BRACHIAL PLEXUS WITHOUT CONTRAST -­‐ TO IDENTIFY APICAL LUNG CANCERS
BRACHIAL PLEXUS WITH CONTRAST
-­‐ TO IDENTIFY APICAL LUNG CANCERS
BRACHIAL PLEXUS W-­‐W/O CONTRAST
-­‐ TO IDENTIFY APICAL LUNG CANCERS
BRACHIAL PLEXUS WITHOUT CONTRAST
-­‐ EVALUATION OF TUMOR IN AXILLA
BRACHIAL PLEXUS WITH CONTRAST
-­‐ EVALUATION OF TUMOR IN AXILLA
BRACHIAL PLEXUS W-­‐W/O CONTRAST
-­‐ EVALUATION OF TUMOR IN AXILLA
BRACHIAL PLEXUS WITHOUT CONTRAST
-­‐ EVALUATION OF TUMOR IN SHOULDER GIRDLE
BRACHIAL PLEXUS WITH CONTRAST
-­‐ EVALUATION OF TUMOR IN SHOULDER GIRDLE
BRACHIAL PLEXUS W-­‐W/O CONTRAST
-­‐ EVALUATION OF TUMOR IN SHOULDER GIRDLE
BRACHIAL PLEXUS WITHOUT CONTRAST -­‐ EVALUATION TO
74181
74182
74183
71550
ORBIT, FACE AND/OR NECK WITHOUT CONTRAST
ORBIT, FACE AND/OR NECK WITH CONTRAST
ORBIT, FACE AND OR/NECK W-­‐W/O CONTRAST
PELVIS -­‐ WITHOUT CONTRAST
PELVIS -­‐ WITH CONTRAST
PELVIS -­‐ W-­‐W/O CONTRAST
PELVIS W-­‐W/O PROTOCOL STUDY
PITUITARY WITHOUT CONTRAST
PITUITARY WITH CONTRAST
PITUITARY W-­‐W/O CONTRAST
PROSTATE WITHOUT CONTRAST
PROSTATE WITH CONTRAST
PROSTATE W-­‐W/O CONTRAST
SACRUM WITHOUT CONTRAST
SACRUM WITH CONTRAST
SACRUM W-­‐W/O CONTRAST
SINUS WITHOUT CONTRAST
SINUS WITH CONTRAST
SINUS W-­‐W/O CONTRAST
TEMPORAL/MASTOID (BRAIN) WITHOUT CONTRAST
TEMPORAL/MASTOID (BRAIN) WITH CONTRAST
TEMPORAL/MASTOID (BRAIN) W/WO CONTRAST
70540
70542
70543
72195
72196
72197
72197
70551
70552
70553
72195
72196
72197
72195
72196
72197
70540
70542
70543
70551
70552
70553
THIGH FEMUR WITHOUT CONTRAST
THIGH FEMUR WITH CONTRAST
THIGH FEMUR W-­‐W/O CONTRAST
THORACIC SPINE WITHOUT CONTRAST
THORACIC SPINE WITH CONTRAST
THORACIC SPINE W-­‐W/O CONTRAST
TMJ WITHOUT CONTRAST
UNLISTED PROCEDURE
UPPER EXTREMITY (NON-­‐JOINT)
FOREARM WITHOUT CONTRAST
FOREARM WITH CONTRAST
FOREARM W-­‐W/O CONTRAST
HAND WITHOUT CONTRAST
HAND WITH CONTRAST
HAND W-­‐W/O CONTRAST
HUMERUS WITHOUT CONTRAST
HUMERUS WITH CONTRAST
HUMERUS W-­‐W/O CONTRAST
SCAPULA WITHOUT CONTRAST
SCAPULA WITH CONTRAST
SCAPULA W-­‐W/O CONTRAST
UPPER EXTREMITY NON JOINT WITHOUT CONTRAST
UPPER EXTREMITY NON JOINT WITH CONTRAST
UPPER EXTREMITY NON JOINT W-­‐W/O CONTRAST
UPPER EXTREMITY (JOINT)
ELBOW WITHOUT CONTRAST
ELBOW WITH CONTRAST
ELBOW W-­‐W/O CONTRAST
FINGER WITHOUT CONTRAST
FINGER WITH CONTRAST
FINGER W-­‐W/O CONTRAST
SHOULDER WITHOUT CONTRAST
SHOULDER WITH CONTRAST
SHOULDER W-­‐W/O CONTRAST
WRITS WITHOUT CONTRAST
WRIST WITH CONTRAST
WRIST W-­‐W/O CONTRAST
WRIST W-­‐W/O PFIZER PROTOCOL
73718
73719
73720
72146
72147
72157
70336
76498
IDENTIFY HEAD/NECK CA TO LEVEL OF THYROID
BRACHIAL PLEXUS WITH CONTRAST -­‐ EVALUATION TO IDENTIFY HEAD/NECK CA TO LEVEL OF THYROID
BRACHIAL PLEXUS W-­‐W/O CONTRAST -­‐ EVALUATION TO IDENTIFY HEAD/NECK CA TO LEVEL OF THYROID
BRAIN -­‐ WITHOUT CONTRAST
BRAIN -­‐ WITH CONTRAST
BRAIN -­‐ W-­‐W/O CONTRAST
BREAST BILATERAL
BREAST UNILATERAL
CARDIAC FOR MORPHOLOGY & FUNCTION -­‐ W/O CONTRAST
CARDIAC FOR MORPHOLOGY AND FUNCTION -­‐ WITHOUT CONTRAST, WITH STRESS IMAGING
+ VELOCITY FLOW MAPPING (USE WITH 75557, 75559)
CARDIAC FOR MORPHOLOGY AND FUNCTION
W -­‐ W/O CONTRAST
CARDIAC FOR MORPHOLOGY AND FUNCTION
-­‐ W-­‐W/O CONTRAST, WITH STRESS IMAGING
+ VELOCITY FLOW MAPPING (USE WITH 75561, 75563)
CERVICAL SPINE WITHOUT CONTRAST
CERVICAL SPINE WITH CONTRAST
CERVICAL SPINE W-­‐W/O CONTRAST
CHEST -­‐ WITHOUT CONTRAST
CHEST -­‐ WITH CONTRAST
CHEST -­‐ W-­‐W/O CONTRAST
ENTEROGRAPHY WITHOUT CONTRAST
ENTEROGRAPHY WITH CONTRAST
ENTEROGRAPHY W-­‐W/O CONTRAST
FETUS WITHOUT CONTRAST
FETUS WITH CONTRAST
FETUS W-­‐W/O CONTRAST
IACS WITHOUT CONTRAST
IACS WITH CONTRAST
IACS WITH-­‐W/O CONTRAST
LUMBAR SPINE WITHOUT CONTRAST
LUMBAR SPINE WITH CONTRAST
LUMBAR SPINE W-­‐W/O CONTRAST
MRCP
71551
71552
73218
73219
73220
73221
73222
73223
70540
70542
70543
70551
70552
70553
77059
77058
75557
75559
75565
75561
75563
75565
72141
72142
72156
71550
71551
71552
74181, 72195 &
76376 or 76377
74182, 72196 & 76376 or 76377
74183, 72197 & 76376 or 76377
72195
72196
72197
70551
70552
70553
72148
72149
72158
74181 &
76376 or 76377
73218
73219
73220
73218
73219
73220
73218
73219
73220
73218
73219
73220
73218
73219
73220
73221
73222
73223
73221
73222
73223
73221
73222
73223
73221
73222
73223
73223
MRI
LOWER EXTREMITY (NON-­‐JOINT)
FOOT WITHOUT CONTRAST
FOOT WITH CONTRAST
FOOT W-­‐W/O CONTRAST
LOWER EXTREMITY WITHOUT CONTRAST
LOWER EXTREMITY WITH CONTRAST
LOWER EXTREMITY W-­‐W/O CONTRAST
THIGH/FEMUR WITHOUT CONTRAST
THIGH/FEMUR WITH CONTRAST
THIGH/FEMUR W-­‐W/O CONTRAST
TIB FIB WITHOUT CONTRAST
TIB FIB WITH CONTRAST
TIB FIB W-­‐W/O CONTRAST
LOWER EXTREMITY (JOINT)
ANKLE POST ARTHROGRAM
ANKLE WITHOUT CONTRAST
ANKLE WITH CONTRAST ANKLE W-­‐W/O CONTRAST
HIP WITHOUT CONTRAST
HIP WITH CONTRAST
HIP W-­‐W/O CONTRAST
KNEE WITHOUT CONTRAST
KNEE WITH CONTRAST
KNEE W-­‐W/O CONTRAST
LOWER EXTREMITY JOINT WITHOUT CONTRAST
LOWER EXTREMITY JOINT WITH CONTRAST
LOWER EXTREMITY JOINT W-­‐W/O CONTRAST
ARTHROGRAM -­‐ Conventional (RAD) W MRI
ANKLE
ELBOW
HIP
KNEE
SHOULDER
WRIST
WRIST 3 JOINT
SACROILIAC (SI) JOINT TMJ
ARTHROGRAM -­‐ Non-­‐Conventional W MRI
ANKLE
ELBOW
HIP
KNEE
SHOULDER
WRIST
WRIST 3 JOINT
SACROILIAC (SI) JOINT TMJ
CPT Code
73718
73719
73720
73718
73719
73720
73718
73719
73720
73718
73719
73720
73722
73721
73722
73723
73721
73722
73723
73721
73722
73723
73721
73722
73723
73722, 27648, 73615
73222, 24220, 73085
73722, 27093, 73525
73722, 27370, 73580
73222, 23350, 73040
73222, 25246, 73115
73222, 25246, 73115
27096, 72196
70336, 21116, 70332
73722, 27648, 77002
73222, 24220, 77002
73722, 27093, 77002
73722, 27370, 77002
73222, 23350, 77002
73222, 25246, 73115
73222, 25246, 77002
27096, 72196
70336, 21116, 77002
MRI
MRA
ABDOMEN CHEST HEAD WITHOUT CONTRAST
HEAD WITH CONTRAST
HEAD W-­‐W/O CONTRAST
LOWER EXTREMITY NECK WITHOUT CONTRAST
NECK WITH CONTRAST
NECK W-­‐W/O CONTRAST
PELVIS
RUN-­‐OFF STUDY (ABDOMINAL AORTA & BILATERAL LWR EXTREMITIES)
SPINAL CANAL AND CONTENTS
UPPER EXTREMITY MRV
MRV HEAD WITHOUT CONTRAST
MRV HEAD WITH CONTRAST
MRV HEAD WITH W/O CONTRAST
OTHER
SPECTROSCOPY (ANY AREA OF THE BODY)
ULISTED MRI PROCEDURE
MYELOGRAM
POSTERIOR FOSSA
CPT Code
74185
71555
70544
70545
70546
73725
70547
70548
70549
72198
74185, 73725 x 2
72159
73225
70544
70545
70546
76390
76498
CERVICAL SPINE
70552, 70010, 77003 & 61055 or 62284
70552, 70015, 77003 &
61055 or 62284
62302, 72142
CERVICAL C-­‐1-­‐C2
62302, 72142
THORACIC SPINE
62303, 72147 LUMBAR
62304, 72149 2 OR MORE REGIONS (EG, LUMBAR/THORACIC, THORACIC/CERVICAL, LUMBAR/CERVICAL)
+and APPROPRIATE 2 MR CODES, BASED ON REGIONS
62305
CISTERNOGRAPHY
Ultrasound
CPT Code
Ultrasound
CPT Code
ABDOMEN
ABDOMEN LTD
LOWER BACK
AORTA ABDOMINAL (AORTA BACKWALL)
AAA SCREENING FOR NON-­‐MEDICARE PATIENTS
AAA SCREENING FOR MEDICARE PATIENTS
BONE DENSITY MEASUREMENT/INTERPRETATION, PERIPHERAL
BREAST UNILATERAL INCL AXILLA IF PERFORMED
BREAST UNILATERAL, LIMITED
CHEST/MEDIASTINUM
UPPER BACK
EXTREMITY NON VASCULAR COMPLETE
EXTREMITY NON VASCULAR LTD
AXILLA -­‐ INDICATIONS RELATING TO ARM/ARM PIT GROIN
GALLBLADDER
INFANT HIPS
INFANT HIPS LIMITED
HYSTEROSONOGRAPHY (SONOHYSTERGRAPHY)
KIDNEY DOPPLER
LIVER
NECK/HEAD SOFT TISSUE
NEONATAL BRAIN
PELVIS LTD -­‐ NON OB
BUTTOCK
PENIS
PERINEUM
PELVIS COMPLETE -­‐ NON OB
PROSTATE VOLUME STUDY
RENAL COMPLETE
RENAL LTD
RENAL TRANSPLANT
RETROPERITONEAL COMPLETE
RETROPERITONEAL LTD
SPINAL CANAL
SPINAL CANAL INFANTS
TRANSVAGINAL APPROACH -­‐ NON OB
TESTICULAR/SCROTUM
THYROID
TRANSRECTAL
URINARY BLADDER
OBSTETRICAL
OB BIOPHYSICAL PROFILE WITH NON-­‐STRESS TESTING
OB BIOPHYSICAL PROFILE W/OUT NON-­‐STRESS TESTING
OB FOLLOW UP EXAM, PER FETUS
OB GREATER THAN 14 WEEKS -­‐ SINGLE FETUS
+ EACH ADDITIONAL FETUS (USE IN ADDITION TO 76805)
76700
76705
76705
76775
76775
G0389
76977
VASCULAR
ABI SINGLE LEVEL -­‐ BILATERAL/UNILATERAL
ABI 2 LEVELS -­‐ BILATERAL/UNILATERAL
ABI 3 LEVELS -­‐ UNILATERAL
ABI COMPLETE -­‐ 3 LEVELS, BILATERAL
AORTA AND/OR IVC DUPLEX LIMITED
AORTA IVC DUPLEX COMPLETE
93922
93922
93922
93923
93979
93978
76641
76642
76604
76604
76881
76882
76882
76882
76705
76885
76886
76831, 58340
93975
76705
76536
76506
76857
76857
76857
76857
76856
76873
76770
76775
76776
76770
76775
76800
76800
76830
76870
76536
76872
76775
ART BILAT LOWER EXTREMITY
ART BILAT UPPER EXTREMITY
ART HEMODIALYSIS ACCESS ** AV FISTULA
ART REST STRESS LOWER EXTREMITY
ART UNILAT LOWER EXTREMITY
ART UNILAT UPPER EXTREMITY
CAROTID DUPLEX -­‐ COMPLETE
CAROTID DUPLEX -­‐ LIMITED
DUPLEX SCAN OF ABDOMINAL, PELVIC, SCROTAL AND/OR RETROPERITONEAL ORGANS -­‐ COMPLETE
DUPLEX SCAN OF ABDOMINAL, PELVIC, SCROTAL AND/OR RETROPERITONEAL ORGANS -­‐ LTD
PENILE DOPPLER
PENILE DOPPLER FOLLOW UP OR LIMITED
TRANSCRANIAL DOPPLER -­‐ COMPLETE
TRANSCRANIAL DOPPLER -­‐ LIMITED
VENOUS DOPPLER EXT BILATERAL
VENOUS DOPPLER EXT UNILATERAL
THORACENTESIS/PARACENTESIS
CHEST TUBE EXTENDED USE
PARACENTESIS
THORACENTESIS
THORACENTESIS WITH TUBE
GUIDED BIOPSY
THIGH CORE
THIGH FNA
THYROID FNA (x # OF NODULES)
THYROID CORE (x # OF NODULES)
THYROID CYST ASPIRATION
OTHER
FOLLOW UP STUDY (SPECIFY)
UNLISTED PROCEDURE
MEASUREMENT OF POST-­‐VOIDING RESIDUAL URINE AND/OR URINARY BLADDER (NON-­‐IMAGING)
VESSEL MAPPING FOR HEMODIALYSIS ACCESS -­‐ MEDICARE PATIENTS
MUSCLE INJ
SINGLE OR MULTIPLE -­‐ 1 OR 2 MUSCLE(S)
SINGLE OR MULTIPLE -­‐ 3 OR MORE MUSCLE(S)
OB LESS THAN 14 WEEKS -­‐ SINGLE FETUS
+ EACH ADDITIONAL FETUS (USE IN ADDITION TO 76801)
OB FETAL AND MATERNAL EVALUATION PLUS DETAILED FETAL ANATOMIC EXAM, TRANSABDOMINAL
+ EACH ADDITIONAL FETUS (USE IN ADDITION TO 76811)
FETAL ECHOCARDIOGRAPHY
FETAL ECHOCARDIOGRAPHY FOLLOWUP / REPEAT STUDY
FETAL DOPPLER
FETAL DOPPLER FOLLOW UP OR REPEAT STUDY
76801
76802
76811
76818
76819
76816
76805
76810
76812
76825
76826
76827
76828
93925
93930
93990
93924
93926
93931
93880
93882
93975
93976
93980
93981
93886
93888
93970
93971
32551
49083
32555
32557
76942, 20206
76942, 10022
76942, 10022
76942, 60100
76942, 60300
76970
76999
51798
G0365
20552, 76942
20553, 76942
X-­‐ray
CPT Code
X-­‐ray
CPT Code
ABDOMNEN -­‐ SINGLE VIEW
SITZMARKS STUDY
74000
74000 PER DAY
72120
72114
ABDOMEN -­‐ AP PLUS OBLIQUE AND CONE VIEWS
ABDOMEN -­‐ COMPLETE INCLUDING DECUBITUS AND/OR ERECT VIEWS
ABDOMEN -­‐ COMPLETE ACUTE SERIES, INCLUDING SUPINE, ERECT, AND/OR DECUBITUS VIEWS + 1 VIEW CHEST
AC JOINTS -­‐ WITH OR WITHOUT WEIGHTED DISTRACTION
ANKLE COMPLETE -­‐ MIN 3 VIEWS
ANKLE LTD -­‐ 2 VIEWS
BONE AGE
BONE LENGTH -­‐ SCANOGRAM
BONE SKELETON SURVEY COMPLETE
BONE SKELETON SURVEY LTD
BONE SURVEY INFANT
CERVICAL SPINE -­‐ 2 OR 3 VIEWS
74010
74020
LUMBAR SPINE FLEX EXT ONLY -­‐ 2 OR 3 VIEWS
LUMBAR SPINE COMPLETE INCLUDING FLEXION/EXTENSION -­‐ MIN 6 VIEWS
MANDIBLE COMPLETE -­‐ MIN 4 VIEWS
MANDIBLE LIMITED -­‐ LESS THAN 4 VIEWS
74022
MASTOID COMPLETE -­‐ MIN 3 VIEWS PER SIDE
70130
73050
73610
73600
77072
77073
77075
77074
77076
72040
MASTOIDS LIMITED -­‐ LESS THAN 3 VIEWS PER SIDE
NASAL BONES COMPLETE MIN 3 VIEWS
NECK SOFT TISSUE
OPTIC FORAMINA
ORBITS COMPLETE -­‐ MIN 4 VIEWS
ORTHOPANTOGRAM AKA "PANORAMIC X-­‐RAY"
PELVIS LTD -­‐ 1 OR 2 VIEWS
PELVIS COMPLETE -­‐ MIN 3 VIEWS
PHARYNX OR LARYNX INCLUDING FLOURO AND/OR MAGNIFICATION TECHNIQUE AKA "NASOPHARYNGOGRAM"
70120
70160
70360
70190
70200
70355
72170
72190
70370
CERVICAL SPINE -­‐ 4 OR 5 VIEWS
CERVICAL SPINE -­‐ 6 OR MORE VIEWS
CHEST COMPLETE -­‐ MIN 4 VIEWS
CHEST COMPLETE W/FLUOROSCOPY
CHEST SPECIAL VIEWS ( EG, LATERAL, DECUBITUS, BUCKY STUDIES)
CHEST -­‐ SINGLE VIEW -­‐ PA
CHEST -­‐ 2 VIEWS -­‐ PA/LAT
CHEST STEREO -­‐ FRONTAL
CHEST -­‐ 2 VIEWS WITH LORDOTIC PROCEDURE
CHEST -­‐ 2 VIEWS WITH OBLIQUES
CHEST -­‐ 2 VIEWS WITH FLOUROSCOPY
CLAVICLE
ELBOW LTD -­‐ 2 VIEWS
ELBOW COMPLETE -­‐ MIN 3 VIEWS
EYE -­‐ FOR DETECTION OF FOREIGN BODY
FACIAL BONES LTD -­‐ LESS THAN 3 VIEWS
FACIAL BONES COMPLETE -­‐ MIN 3 VIEWS
FEMUR FINGER
FOOT LTD -­‐ 2 VIEWS
FOOT COMPLETE -­‐ MIN 3 VIEWS
FOREARM HAND LTD -­‐ 2 VIEWS
HAND COMPLETE -­‐ MIN 3 VIEWS
HEEL (CALCANEUS)
HIP BILATERAL -­‐ MIN 2 VIEWS EACH WITH AP VIEW OF PELVIS HIP UNILATERAL LTD -­‐ 1 VIEW
HIP UNILATERAL COMPLETE -­‐ MIN 2 VIEWS
HUMERUS
INFANT OR CHILD HIPS AND PELVIS INFANT -­‐ LOWER EXTREMITY
INFANT -­‐ UPPER EXTREMITY
INTERNAL AUDITORY MEATI COMPLETE
JOINT SURVEY, SINGLE VIEW, 2 OR MORE JOINTS
KNEE -­‐ 1 OR 2 VIEWS
KNEE -­‐ 3 VIEWS
KNEE AP STANDING -­‐ BILATERAL
KNEE COMPLETE -­‐ 4 OR MORE VIEWS
KUB
LUMBAR SPINE -­‐ 2 OR 3 VIEWS
LUMBAR SPINE -­‐ 4 OR MORE VIEWS
72050
72052
71030
71034
71035
71010
71020
71015
71021
71022
71023
73000
73070
73080
70030
70140
70150
73550
73140
73620
73630
73090
73120
73130
73650
73520
RIBS BILATERAL -­‐ 3 VIEWS
RIBS BILATERAL W/PA CHEST -­‐ 4 VIEWS
RIBS UNILATERAL -­‐ 2 VIEWS
RIBS UNILATERAL W/PA CHEST -­‐ MIN 3 VIEWS
SACRUM & COCCYX -­‐ MIN 2 VIEWS
SALIVARY GLAND FOR CALCULUS
SCAPULA
SCOLIOSIS STUDY
SELLA TURCICA AKA "TURKISH SADDLE"
SHOULDER LTD -­‐ 1 VIEW
SHOULDER COMPLETE -­‐ MIN 2 VIEWS
SI JOINTS COMPLETE -­‐ MIN 3 VIEWS
SI JOINTS LTD -­‐ LESS THAN 3 VIEWS
SINUS/PARANASAL LTD -­‐ LESS THAN 3 VIEWS
SINUS/PARANASAL COMPLETE -­‐ MIN 3 VIEWS
SKULL LTD -­‐ LESS THAN 4 VIEWS
SKULL COMPLETE -­‐ MIN 4 VIEWS
SPINE -­‐ 1 VIEW (SPECIFY LEVEL)
SPINE -­‐ ENTIRE SURVEY STUDY STERNOCLAVICULAR JOINT OR JOINTS -­‐ MIN 3 VIEWS
STERNUM -­‐ MIN 2 VIEWS
TEETH -­‐ SINGLE VIEW
TEETH -­‐ PARTIAL EXAMINATION, LESS THAN FULL MOUTH
TEETH -­‐ COMPLETE -­‐ FULL MOUTH
THORACIC SPINE -­‐ 3 VIEWS
THORACIC SPINE -­‐ MIN 4 VIEWS
71110
71111
71100
71101
72220
70380
73010
72090
70240
73020
73030
72202
72200
70210
70220
70250
70260
72020
72010
71130
71120
70300
70310
70320
72072
72074
73500
73510
73060
73540
73592
73092
70134
77077
73560
73562
73565
73564
74000
72100
72110
72070
72080
72069
73590
70330
70328
73660
73100
73110
LUMBAR SPINE FLEX EXT ONLY -­‐ 2 OR 3 VIEWS
72120
LUMBAR SPINE COMPLETE INCLUDING FLEXION/EXTENSION -­‐ MIN 6 VIEWS
72114
THORACIC SPINE -­‐ 2VIEWS -­‐ AP/LAT
THORACOLUMBAR SPINE -­‐ 2 VIEWS
THORACOLUMBAR SPINE -­‐ STANDING (SCOLIOSIS)
TIBIA FIBULA
TMJ -­‐ BILATERAL
TMJ -­‐ UNILATERAL
TOE(S)
WRIST LTD -­‐ 2 VIEWS
WRIST COMPLETE -­‐ MIN 3 VIEWS
OTHER
UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE
DEXA
SCAN BODY FAT ASSESSMENT
BONE DENSITY; AXIAL SKELETON (HIPS, SPINE, PELVIS)
BONE DENSITY, AXIAL SKELETON, INCLUDING VERTEBRAL FRACTURE ASSESSMENT
BONE DENSITY; APPENDICULAR SKELETON (RADIUS, WRIST, HEEL)
DEXA SCAN; VERTEBRAL FRACTURE ASSESSMENT ONLY
70110
70100
76499
76499
77080
77085
77081
77086
Nuclear Medicine
CPT Code
ABSCESS LOCALIZATION LIMITED
ADRENAL IMAGING, CORTEX AND/OR MEDULLA
BONE MARROW IMAGING LTD AREA
78805, A9569, A9556 * TUMOR LOCALIZATION -­‐ MULTIPLE AREAS
78806, A9569, A9556 *
TUMOR LOCALIZATION -­‐ WHOLE BODY, SINGLE DAY
78807, A9560, A9572, A9569, A9500, A9556 * TUMOR LOCALIZATION -­‐ WHOLE BODY SPECT, SINGLE DAY
78806, 78807, A9560, A9572, A9569, A9500, A9556 *
TUMOR LOCALIZATOIN -­‐ WHOLE BODY, 2 OR MORE DAYS
78075, A9508, A9582 or A9548 *
TUMOR LOCALIZATION -­‐ WHOLE BODY SPECT, 2 OR MORE DAYS
78102, A9541
GASTRIC EMPTYING SCAN xs 2
BONE MARROW IMAGING MULTIPLE AREAS
BONE MARROW IMAGING WHOLE BODY
78103, A9541
78104, A9541
ABSCESS LOCALIZATION WHOLE BODY
ABSCESS LOCALIZATION SPECT
ABSCESS LOCALIZATION SPECT WHOLE BODY
BONE SCAN 3 PHASE
BONE OR JOINT IMAGING; LIMITED AREA
BONE OR JOINT IMAGING; MULTIPLE AREAS
BONE SCAN SPECT STUDY BONE OR JOINT IMAGING; WHOLE BODY
BONE OR JOINT IMAGING; WHOLE BODY WITH SPECT
BRAIN IMAGING LESS THAN 4 STATIC VIEWS
BRAIN IMAGING LESS THAN 4 STATIC VIEWS WITH VASCULAR FLOW
BRAIN IMAGING MINIMUM 4 STATIC VIEWS
BRAIN IMAGING MINIMUM 4 STATIC VIEWS WITH VASCULAR FLOW
BRAIN SPECT SCAN
BRAIN IMAGING VASCULAR FLOW ONLY
CARDIAC SHUNT IMAGING/DETECTION
CEA SPECT SCAN
78315, A9561 or A9503 *
78300, A9561 or A9503 *
78305, A9561 or A9503 *
78320
78306, A9561 or A9503 *
78306, 78320, A9561 or A9503 *
78600, A9569
Nuclear Medicine
ACUTE GI BLOOD LOSS IMAGING
HIDA SCAN
HIDA SCAN WITH PHARMACOLOGIC INTERVENTION (CCK)
LIVER SCAN STATIC ONLY LIVER SCAN WITH VASCULAR FLOW
78201, A9541
78202, A9541
LIVER IMAGING SPECT (3D)
78205, A9541
LIVER SPECT SCAN WITH VASCULAR FLOW
LIVER & SPLEEN IMAGING STATIC ONLY 78206, A9541
78215, A9541
78601, A9569
78605, A9569
LIVER & SPLEEN IMAGING WITH VASCULAR FLOW
LYMPHATICS AND LYMPH NODE IMAGING
78216, A9541
78195, A9541
78606, A9569
78607, A9569 78610, A9569 MECKELS SCAN MIBG SPECT SCAN I 123
MIBG SPECT SCAN 1 131
78428, A9540
78803, A9560, A9572, A9569, A9500, A9556 *
78804, A9560, A9572, A9569, A9500, A9556 *
MUGA; PLANAR, SINGLE STUDY AT REST OR STRESS
+ RIGHT VENTRICULAR EJECTION FRACTION (USE WITH 78472)
CEA WHOLE BODY SCAN SINGLE DAY
GALLIUM SCAN LTD AREA -­‐ TUMOR LOCALIZATION
GALLIUM SCAN WHOLE BODY MULTI DAY -­‐ TUMOR LOCALIZATION
GALLIUM SCAN WHOLE BODY SINGLE DAY -­‐ TUMOR LOCALIZATION 78804, A9560, A9572, A9569, A9500, A9556 *
78803, 78804, A9560, A9572, A9569, A9500, A9556 *
78264, A9541
78278, A9560 or A9541 *
78226, A9537
78227, A9537, J2805 (kinevac/CCK) or J2275 (morphine)
78018, A9528
78290, A9512
78803, 78804, A9582
78803, 78804, A9508
78472, A9560, A9512, A9538 *
78496
MUGA; MULTIPLE STUDIES, WALL MOTION STUDY PLUS EJECTION FRACTION, AT REST AND STRESS
78473, A9560, A9512, A9538 *
MUGA SPECT
78494, A9560, A9512, A9538
78802, A9560, A9572, A9569, A9500, A9556 *
CISTERNOGRAM
CSF LEAKAGE DETECTION AND LOCALIZATION
78801, A9560, A9572, A9569, A9500, A9556 *
78802, A9560, A9572, A9569, A9500, A9556 *
78803, A9560, A9572, A9569, A9500, A9556 *
I 131 BODY SCAN
CEA WHOLE BODY SCAN MULTI DAY
CEA WHOLE BODY MULTI DAY SPECT
CPT Code
78803, 78804, A9560, A9572, A9569, A9500, A9556 *
OCTREOSCAN SPECT
78630, 62311, 77003, A9548, 62310
OCTREOSCAN WHOLE BODY MULTI DAY
78650
OCTRESCAN WHOLE BODY MULTI DAY W/SPECT
78800, A9560, A9572, A9569, A9500, A9556 *
OCTREOSCAN WHOLE BODY SINGLE DAY
78804, A9560, A9572, A9569, A9500, A9556 *
PARATHYROID IMAGING WITHOUT SPECT
78803, A9572
78804, A9572
78803, 78804, A9572
78802, A9572
78070, A9500
78802, 78803, A9560, A9572, A9569, A9500, A9556 *
PARATHYROID IMAGING WITH SPECT
PARATHYROID IMAGING WITH SPECT AND CT FOR ANATOMICAL LOCALIZATION
78071, A9500
78072, A9500
Nuclear Medicine
CPT Code
PET CT LIMITED AREA
78814, A9552
PET CT SKULL BASE TO MID THIGH
78815, A9552
PET CT WHOLE BODY
78816, A9552
PET MYOCARDIAL IMAGING METABOLIC EVALUATION
78459
PET MYOCARDIAL PERFUSION; SINGLE STUDY AT REST OR STRESS
78491
PET MYOCARDIAL PERFUSION; MULTIPLE STUDIES AT REST OR STRESS
78492
PET BRAIN METABOLIC EVALUATION
78608, A9552
PROSTASCINT MULTI DAY SPECT NEEDS ABD/PEL W/WO TOO
78803, 78804, A9507
THYROID UPTAKE SINGLE OR MULTIPLE
THYROID IMAGING INCLUDING VASCULAR FLOW, IF PERFORMED
THYROID IMAGING WITH SINGLE OR MULTIPLE UPTAKES
78012, A9516
78015, A9528
78582, A9540, A9567
THYROID CARCINOMA METASTASES LTD
THYROID CARCINOMA METASTASES WITH ADDITIONAL STUDIES
THYROID CARCINOMA METASTASES WHOLE BODY SCAN
+ THYROID CARCINOMA METASTASES UPTAKE (USE WITH 78018)
URETAL REFLUX STUDY (RADIOPHARMACEUTICAL VOIDING CYSTOGRAM)
78598, A9540, A9567
+ URINARY BLADDER RESIDUAL STUDY (USE WITH 78740)
78597
79005, A9517
OTHER
UNLISTED ENDOCRINE PROCEDURE
UNLISTED HEMATOPOIETIC, RETICULOENDOTHELIAL AND LYMPHATIC PROCEDURE
UNLISTED GASTROINTESTINAL PROCEDURE
UNLISTED MUSCOSKELETAL PROCEDURE
UNLISTED CARDIOVASCULAR PROCEDURE
UNLISTED RESPIRATORY PROCEDURE
UNLISTED NERVOUS SYSTEM PROCEDURE
78802, A9507
78804, A9507
PULMONARY PERFUSION PARTICULATE ONLY
PULMONARY VENTILATION AND PERFUSION SCAN (AKA VQ SCAN)
PULMONARY PERUSION AND VENTILATION WITH QUANTITATIVE DIFFERENTIAL
QUANTITATIVE DIFFERENTIAL PULMONARY PERFUSION, INCLUDING IMAGING WHEN PERFORMED
RA I 131 THYROID ABLATION THERAPY (#1)
78580, A9540
RENAL FUNCTION STUDY
RENAL SCAN W/CAPTOPRIL MULTIPLE STUDIES
RENAL SCAN W/CAPTOPRIL SINGLE STUDY
RENAL SCAN W/LASIX MULTIPLE STUDIES
RENAL SCAN W/LASIX SINGLE STUDY
RENAL SCAN MORPHOLOGY
78725, A9539
78709, A9562, J1940
78708, A9562, J1940
78709, A9562, J1940
78708, A9562, J1940
78700
78701, A9562, A9551, A9539 *
SALIVARY GLAND FUNTION STUDY
CPT Code
78230, A9512
78231, A9512
78803, A9500
78761, A9512
PROSTASCINT WHOLE BODY SINGLE
PROSTASCINT WHOLE BODY MULTI W OUT SPECT
RENAL SCAN WITH VASCULAR FLOW
RENAL SCAN WITH VASCULAR FLOW AND FUNCTION, SINGLE STUDY W/OUT PHARM INTERVENTION
RENAL SPECT SCAN
Nuclear Medicine
SALIVARY GLAND IMAGING
SERIAL SALIVARY IMAGING
SESTAMIBI SCAN
TESTICULAR IMAGING WITH VASCULAR FLOW
78707
78710
78232, A9512
78013, A9516
78014, A9516
78016, A9528
78018, A9528
78020
78740
78730
78099
78199
78299
78399
78499
78599
78699
UNLISTED GENITOURINARY PROCEDURE
78799
UNLISTED MISCELLANEOUS PROCEDURE
UNLISTED RADIOPHARMACEUTICAL THERAPY PROCEDURE
INJECTION PROCEDURE FOR RADIOPHARMACEUTICAL LOCALIZATION BY NON-­‐IMAGING PROBE STUDY, INTRAVENOUS
78999
79999
78808
Biopsy, Drainge & Aspiration
CPT Code
Muscle/Soft Tissue
20206 with either 76942 (US), 77012 (CT), 77002 (FL) or 77021 (MR)
Bone Superficial (eg, sternum, ilium, rib)
20220 with either 76942 Paracentesis
(US), 77012 (CT), 77002 (FL) or 77021 (MR)
49083
Bone Deep (eg, femur, vertebral body)
20225 with either 76942 Thoracentesis
(US), 77012 (CT), 77002 (FL) or 77021 (MR)
32555
Pleura 32400 with either 76942 Aspiration of Hematoma, Bulla, ABSCES or Cyst
(US), 77012 (CT), 77002 (FL) or 77021 (MR)
10160 with either 76942 (US), 77012 (CT), 77002 (FL) or 77021 (MR)
Lung or Mediastinum
32405 with either 76942 Aspiration; renal cyst or pelvis
(US), 77012 (CT), 77002 (FL) or 77021 (MR)
50390 with either 76942 (US), 77012 (CT), 77002 (FL) or 77021 (MR)
Bone Marrow
38221 with either 76942 Aspiration; thyroid cyst
(US), 77012 (CT), 77002 (FL) or 77021 (MR)
60300 with either 76942 (US), 77012 (CT), 77002 (FL) or 77021 (MR)
BONE MARROW -­‐ ASPIRATION ONLY 38220 with either 76942 Incision and Drainage of Hematoma, Seroma or Fluid (US), 77012 (CT), 77002 Collection
(FL) or 77021 (MR)
10140 with either 76942 (US), 77012 (CT), 77002 (FL) or 77021 (MR)
BONE MARROW BIOPSY AND ASPRITATION -­‐ MEDICARE PATIENTS
38221, G0364 with either 76942 (US), 77012 (CT), 77002 (FL) or 77021 (MR)
Lymph Nodes; superficial
38505 with either 76942 FLUID COLLECTION DRAINAGE, WITH IMAGING GUIDANCE, 49405
(US), 77012 (CT), 77002 VISCERAL (EG, LIVER, KIDNEY, SPLEEN, LUNG)
(FL) or 77021 (MR)
Liver
47000 with either 76942 FLUID COLLECTION DRAINAGE, WITH IMAGING GUIDANCE, 49406
(US), 77012 (CT), 77002 PERITONEAL OR RETROERITONEAL THROUH ABDOMINAL (FL) or 77021 (MR)
WALL OR FLANK
Pancreas
48102 with either 76942 FLUID COLLECTION DRAINAGE, WITH IMAGING GUIDANCE, 49407
(US), 77012 (CT), 77002 PERITONEAL OR RETROERITONEAL, T-­‐VAG OR T-­‐RECTAL (FL) or 77021 (MR)
APPROACH Abdominal or Retroperitoneal Mass
49180 with either 76942 INTERVERTEBRAL DISC ASPIRATION
(US), 77012 (CT), 77002 (FL) or 77021 (MR)
62267, 77003
Kidney
50200 with either 76942 CHEST TUBE PLACEMENT AND DRAINAGE
(US), 77012 (CT), 77002 (FL) or 77021 (MR)
32557
Prostate
55700 with either 76942 TUNNELED PLEUARAL CATHETER PLACEMENT
(US), 77012 (CT), 77002 (FL) or 77021 (MR)
32550, 75989
Thyroid; Core 60100 with either 76942 TUNNELED PLEURAL CATHETER REMOVAL
(US), 77012 (CT), 77002 (FL) or 77021 (MR)
32552
Thyroid; FNA (fine needle aspiration) 10022 (per lesion) Insertion of Tunneled Intraperitoneal Catheter
76942
10022 w/either 76942 Insertion of Tunneled Intraperitoneal Catheter with (US), 77012 (CT), 77002 Subcutaneous Port
(FL) or 77021 (MR)
49418
FNA on any area of the body; can be done alone or in addition to a core biopsy
Biopsy, Drainage & Aspiration
CPT Code
FLUID COLLECTION DRAINAGE, WITH IMAGING GUIDANCE, 10030
SOFT TISSUE (EG, ABSCESS, SEROMA, LYMPHOCELE, CYST)
49419
Biopsy, Drainge & Aspiration
CPT Code
Biopsy, Drainage & Aspiration
Removal of Tunneled Intraperitoneal Catheter
49422
REPAIR OF PERIPHERALLY INSERTED CVC W/OUT PORT OR PUMP
Contrast Injection for Assessment of Abscess or Cyst Via Previously Placed Drainage Cath/Tube
Exchange of Previously Placed Abscess or Drainage Catheter
Injection of Sinus Tract DIAGNOSTIC (Sinogram, Fistulogram)
INJECTION OF SINUS TRACT, THERAPEUTIC (NON-­‐
VASCULAR SCLEROTHERAPY)
PICCS & PORTS
NON-­‐TUNNELED CENTRALLY INSERTED < 5 YEARS OLD
49424, 76080
CPT Code
36575, 76937, 77001
NON-­‐TUNNELED CENTRALLY INSERTED ≥ 5 YEARS OLD
36556, 76937, 77001
REPAIR OF NON-­‐TUNNELED CVC
REPLACEMENT OF NON-­‐TUNNELED CVC THROUGH SAME VENOUS ACCESS
TUNNELED CENTRALLY INSERTED W/OUT PORT OR PUMP < 5 YEARS OLD
TUNNELED CENTRALLY INSERTED W/OUT PORT OR PUMP ≥ 5 YEARS OLD
36575, 76937, 77001
REPAIR OF PERIPHERALLY INSERTED CVC WITH PORT
REPLACEMENT (COMPLETE) OF PERIPHERALLY INSERTED CVC W/OUT PORT OR PUMP
REPLACEMENT OF PERIPHERALLY INSERTED CVC WITH PORT (CATH ONLY)
REPLACEMENT (COMPLETE) OF PERIPHERALLY INSERTED CVC WITH PORT
REPAIR OF TUNNELED CVC W/OUT PORT OR PUMP
REPAIR OF TUNNELED CVC WITH PORT
REPLACEMENT OF TUNNELED CVC W/OUT PORT OR PUMP THROUGH SAME VENOUS ACCESS
REPLACEMENT OF TUNNELED CVC WITH PORT THROUGH SAME VENOUS ACCESS
36580, 76937, 77001
REMOVAL OF TUNNELED CVC W/OUT PORT OR PUMP
36589, 76937, 77001
36557, 76937, 77001
REMOVAL OF TUNNELED CVC WITH PORT
36590, 76937, 77001
36558, 76937, 77001
REMOVAL OF TUNNELED CVC WITH PUMP
36590, 76937, 77001
^^^ REQUIRING 2 CATHETERS VIA 2 SEPARTE ACCESS SITES
TUNNELED CENTRALLY INSERTED WITH PORT < 5 YEARS OLD
TUNNELED CENTRALLY INSTERTED WITH PORT ≥ 5 YEARS OLD
36565, 76937, 77001
REMOVAL OF PERIPHERALLY INSERTED CVC
36590, 76937, 77001
36560, 76937, 77001
36595, 75901
^^^ REQUIRING 2 CATHETERS VIA 2 SEPARTE ACCESS SITES
TUNNELED CENTRALLY INSERTED WITH PUMP ≥ 5 YEARLS OLD
REPLACEMENT OF TUNNELED CVC WITH PUMP (CATH ONLY)
REPLACEMENT OF TUNNELED CVC WITH PUMP (COMPLETE) THROUGH SAME VENOUS ACCESS
PERIPHERALLY INSERTED W/OUT PORT OR PUMP (PICC) < 5 YEARS OLD
PERIPHERALLY INSERTED W/OUT PORT OR PUMP (PICC) ≥ 5 YEARS OLD
PERIPHERALLY INSERTED WITH PORT < 5 YEARS OLD
PERIPHERALLY INSERTED WITH PORT ≥ 5 YEARS OLD
36566, 76937, 77001
DECLOTTING BY THROMBOLYTIC AGENT OF CVC
MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTIVE MATERIAL MECHANICAL REMOVAL OF INTRACATHETER OBSTRUCTIVE MATERIAL
36563, 76937, 77001
REPOSITIONING OF CVC
36597, 76000
36578, 76937, 77001
CVC CONTRAST INJECTION
36583, 76937, 77001
IVC FILTER 36568, 76937, 77001
IVC FILTER INSERTION
37191
36569, 76937, 77001
36570, 76937, 77001
36571, 76937, 77001
IVC FILTER REPOSITIONING
IVC FILTER REMOVAL
37192
37193
49423, 75984
20501, 76080
20500, 76080
36555, 76937, 77001
36561, 76937, 77001
36576, 76937, 77001
36584, 76937, 77001
36578, 76937, 77001
36585, 76937, 77001
36575, 76937, 77001
36576, 76937, 77001
36581, 76937, 77001
36582, 76937, 77001
36593
36596, 75902
36598, 75825 or 75827
ICD-­‐9
Abdomen & Pelvic
Abdomen Pain RUQ
Abdomen Pain LUQ
Abdomen Pain RLQ
Abdomen Pain LLQ
Ascites, Other
Ascites, Malignant
Constipation
Diarrhea
Flatulence Gas Pain
Hematuria
Hepatitis NOS
Hepatomegaly
Malaise/Fatigue
Malignant Neo Abd Intra
Malignant Neo Biliary Tract
Malignant Neo Colon
Malignant Neo Liver Not Spec as Primay or Secondary
Nausea w/vomit
Nausea w/o vomiting
Splenomegaly
UTI
Ventral Hernia
Weight Loss, Abnormal
789.01
789.02
789.03
789.04
789.59
789.51
564.00
787.91
787.3
599.70
573.3
789.10
780.79
195.2
156.9
153.9
155.2
787.01
787.02
789.2
599.0
553.20
783.21
Breast
Breast Cancer
Fibrocystic Disease
Lump or Mass
Nipple Discharge
Pain Breast
Screening Mammography
Screening Mammography, high-­‐risk
174.9
610.1
611.72
611.79
611.71
V76.12 V76.11 Female Disorders
Amenorrhea
Bleeding Unrelated to Menstrual Cycle
Dysfunctional Uterine Bleed
Irregular Menstrual Cycle
Menorrhagia
Menstrual Disorder Unspecified
Oligomenorrhea
OB Size & Date
Pelvic Pain
Extremities & Joints Bursitis, Elbow
Ganglion Cyst of Joint
Joint Disorder NOS
Joint Effusion, Ankle
Joint Effusion, site unspecified
Joint Effusion, Hand
Joint Effusion, Shoulder
Joint Stiffness NEC
Medial Meniscus Tear
Pain Forearm, Wrist
Pain Hand
Pain Multi Joint
Pain Shoulder
Pain Upper Arm
Pain Ankle, Foot
Pain Knee
Pain Hip, Pelvic
Rotator Cuff Syndrome
Shoulder Stiffness
Sprain, Strain Rotator Cuff
626.0
626.6
626.8
626.4
626.2
626.9
626.1
V22.1 625.9
726.33
727.41
719.90
719.07
719.00
719.04
719.01
719.5
836.0
719.43
719.44
719.49
719.41
719.42
719.47
719.46
719.45
726.10
719.51
840.4
Head & Neck
Aphasia
Convulsions
CVA NOS
Dizziness Giddiness
Headaches
Lack of Coordination
Mass/Lump Neck/Head
Migraine
MS
Parkinson’s Disease
Speech Disturbance
Stenosis of Carotid
Subdural Hemorrhage
Syncope
TIA
784.3
780.39
434.91
780.4
784.0
781.3
784.2
346.90
340
332.0
784.59
433.10
432.1
780.2
435.9
Orbit, Face & Neck Chronic Sinusitis
Diplopia
Goiter NOS
Hearing Loss
Orbital Disorder
Thyroid Dysfunction
Thyroid Nodule
Tinnitus
Visual Disturbance
Visual Loss, Both Eyes
473.9
368.2
240.9
389.9
376.9
246.9
241.9
388.3
368.9
369
Spine Cervical Radiculopathy
Cervical Pain
Cervical Spondylosis
Cervical Disc Displacement
Cervical Stenosis
Degen of Cervical
Degen of Thoracic
Degen of Lumbar
Lumbar Pain
Lumbar Spondylosis
Lumbar Disc Displacement
Lumbar Stenosis
Thoracic & Lumbar Radiculopathy
Thoracic Pain
Thoracic Spondylosis
Thoracic Disc Displacement
Thoracic Stenosis
Sciatica
723.4
723.1
721.0
722.0
723.0
722.4
722.51
722.52
724.2
721.3
722.10
724.02
724.4
724.1
721.2
722.11
724.01
724.3
Additional Diagnosis
Cellulitis, Arms
Chest Pain
Cough
Numbness
Osteoporosis
Osteopenia
Pain in Limb
Superficial Swelling
Swelling of Limb
682.3
786.50
786.2
782.0
733.00
733.90
729.5
782.2
729.81