2015 CPT CODES MR/CT CT Abdomen without Abdomen with Abdomen with & without Abdomen / Pelvis without Abdomen / Pelvis with Abdomen / Pelvis with & without Abdomen with & without Pelvis with 74150 74160 74170 74176 74177 74178 74178 CTA Abdomen with & without CTA Abdomen Runoff (to toes) CTA Abdomen / Pelvis CTA Cardiac CTA Chest with & without CTA Coronary CTA Head with & without CTA Neck with & without CTA Pelvis with & without 74175 75635 74174 75574 71275 75574 70496 70498 72191 Cervical without Thoracic without Lumbar without 72125 72128 72131 Chest without Chest with Chest with & without Chest PE Protocol 71250 71260 71270 71275 Facial Bones without 70486 Head without Head with Head with & without 70450 70460 70470 Lower Extremity without 73700 Orbits without Orbits with Orbits with & without 70480 70481 70482 Pelvis without Pelvis with Pelvis with & without 72192 72193 72194 S.T. Neck without S.T. Neck with S.T. Neck with & without 70490 70491 70492 Sinus without 70486 Temp Bones / IAC's without 70480 Upper Extremity without Urogram 73200 74178 CT Myelogram Cervical 62302 Thoracic 62303 Lumbar 62304 2 or more 62305 Regions MRI Arthrogram (joint contrast) 73722 73615 Ankle 27648 73722 Hip 73525 27093 73722 Knee 73580 27370 73222 Shoulder 73040 23350 73219 Thumb 77002 20600 73222 Wrist (1 73115 compartment) 25246 73222 Wrist (3 73115 compartment) 25246x Dexascan Axial Skeleton 77080 Plus Vertebral 77085 Fracture ONLY Vertebral 77086 Fracture MRI Abdomen / MRCP Abdomen / MRCP with & without MRA Abdomen MRA Brain MRA Carotid / Neck MRA Chest MRA Pelvis Runoff (to ankle) MRA Pelvis Without Brain without Brain with & without 74181 74183 74185 70544 70547 71555 73725x2 72198 72198 Breast Bilateral without or with & without DX=cander add 70551 70553 70553 70543 77059 . 0159T Cardiac 75557 Cervical without Cervical with & without Thoracic without Thoracic with & without Lumbar without Lumbar with & without 72141 72156 72146 72157 72148 72158 Hip 73721 Brain & Orbits with & without Lower Extremity - Joint Specify: Hip, Knee, Ankle Lower Extremity - Not a Joint Specify: Femur, TibFib, Foot 73721 73718 Orbits without 70540 Pelvis without Pelvis with & without 72195 72197 S.T. Neck without S.T. Neck with & without 70540 70543 TMJ 70336 Upper Extremity - Joint 73221 Specify: Shoulder, Elbow, Wrist Upper Extremity - Not a Joint 73218 Specify: Humerus, Forearm, Hand Breast Biopsy Additional Lesion 19085 19086 Page 1 of 3 Updated 1/31/15 2015 CPT CODES NM/Fluoro/Mammo/US Nuclear Medicine A9503 Bone Scan Whole Body 78306 Bone Scan Limited A9503 Specify: Body Part 78300 Bone Scan 3 Phase A9503 78315 Specify: Body Part A9503 Bone Spect 78320 A9541 Gastric Emptying 78264 A9502 Heart Treadmill A9505 78452 J1245 A9502 Heart Pharmacologic A9505 78452 J1245 A9502 Hida with CCK A9505 78227 A9537 Hida without CCK 78226 A9528 I-131 Whole Body Scan 78018 A9517 I-131 Whole Body Scan 79005 with Therapy 78018 A9517 I-131 Therapy 79005 All I-131 Addt'l Info on Pg 4 A9541 Liver Spect Scan 78205 Liver Spleen 78215 A9567 A9540 Lung VQ 78598 71020 A9560 Muga Scan 78472 A9500 Parathyroid Scan 78070 A9562 Renal Mag 3 78708 A9562 Renal Lasix 78708 A9562 Renal Captopril 78708 A9551 Renal Scan-DMSA 78710 Thyroid Uptake and Scan 78014 A9521 WBC Whole Body 78806 A9521 WBC Limited 78805 Fluoroscopy Barium Swallow Modified Barium Swallow (must have speech pathologist) Barium Enema Barium Enema with Air Hysterosalpinogram Lumbar Puncture Pain Mgmt - Hip Injection Pain Mgmt - Sm Joint Specify: Toes, Fingers Pain Mgmt - Int Joint Specify: Ankle, Wrist, Elbow Pain Mgmt - Lg Joint Specify: Hip Right or Left Small Bowel Follow Through Upper G.I. Barium Swallow Upper G.I. with KUB Upper G.I. with Small Bowel Series 74220 74230 74270 74280 74740 58340 77003 62270 20610 77002 77002 20600 77002 20605 77002 20610 74250 74247 74220 74247 74249 74455 VCUG 51600 Digital Mammography 77052 Screening Bilateral G0202 77052 Screening Unilateral G0202-52 77051 Diagnostic Bilateral G0204 77051 Diagnostic Unilateral G0206 77051 Mag / Spot Bilateral G0204-52 77051 Mag / Spot Unilateral G0206-52 Stereotactic Breast Biopsy 19081 Additional Lesion 19082 Ultrasound Guided Procedures 19083 G0206 Breast Biopsy 77051 A4550 19084 Additional Lesion Breast Cyst Aspiration 76942 19000 Specify: Side, Nodule 76942 Thyroid Biopsy 99070 Specify: Side, Nodule 10022 20206 Soft Tissue Neck Biopsy 76942 Specify: Side, Nodule 99070 Ultrasound Abdominal Complete Abdominal Limited Aorta Iliac IVC for Aneurysm Breast Carotid Chest Doppler, Arterial Bilateral Lower Doppler, Arterial Unilateral Lower Doppler, Arterial Bilateral Upper Doppler, Arterial Unilateral Upper Doppler Aorta Iliac IVC for Transplant Doppler, Mesenteric Doppler Renal Artery Doppler, Portal Vein Doppler, Venous Bilateral Doppler, Venous Unilateral Extremity Specify: Body Part Fetal Hips Head / Soft Tissue Neck HSG OB Single >14wks OB Multiple OB 1st Trimester < 14 wks OB T-Vag Pain Mgmt - Sm Joint Specify: Toes, Fingers Pain Mgmt - Int Joint Specify: Ankle, Wrist, Elbow U/S Pain Mgmt - Lg Joint Specify: Hip Right or Left Paracentesis Pelvis Pelvis with T-Vag Renal Renal Post Transplant Scrotal (Testicular) Thoracentesis Thyroid Transrectal (Prostate) Transvaginal 76700 76705 76705 76641 93880 76604 93925 93926 93930 93931 93978 93976 93975 93976 93970 93971 76880 76885 76536 76831 58340 99070 76805 76810 76801 76817 20604 20606 20611 49083 99070 76856 76856 76830 76770 76776 76870 32555 76536 76872 76830 Page 2 of 3 Updated 1/31/15 2015 CPT CODES Additional Guide for Nuclear Medicine THYROID UPTAKE – SINGLE DETERMINATION * Probe only with one return (2, 4, 6, OR 24HOURS) 78012 THYROID IMAGING, WITH UPTAKE-SINGLE DETERMINATION * Return with probe plus one image of the thyroid gland acquired at 6 hours after dose 78014 THYROID IMAGING WITH UPTAKE-MULTIPLE DETERMINATIONS * Return with probe and Includes the above with two returns for determination 78014 I131 WHOLE BODY SCAN-NO THYROGEN NO HIGH DOSE *TSH >30 *SDMI Dose *SDMI Whole Body Scan A9517 78018 THYROGEN I131 WHOLE BODY SCAN NO HIGH DOSE *Thyrogen given by doctor’s office Monday and Tuesday *SDMI Dose Wednesday *SDMI Whole Body Scan Friday- A9517 78018 I131 WHOLE BODY SCAN WITH HIGH DOSE (29.9 MCI-200MCI) *TSH>30 Pregnancy test Required within 7 days unless Hysterectomy/Tubal Ligation *SDMI High Dose *SDMI Whole Body Scan 1 week after High Dose 79005 78018 THYROGEN I131 WHOLE BODY SCAN WITH HIGH DOSE (29.9 MCI-200MCI) *Pregnancy test Required within 7 days unless Hysterectomy/Tubal Ligation *Thyroid labs within 3 months *Thyrogen given by doctor’s office Monday and Tuesday *SDMI High Dose Wednesday *SDMI Whole Body Scan 1 week after High Dose 79005 78018 Page 3 of 3 Updated 1/31/15