Ordering Guide • Touchstone Medical Imaging

Imaging Exam & CPT Code Finder

Use the inputs below quickly verify the type of imaging exam to order for the medical concern or area of concern. The tool will provide the recommended exam, contrast guidance, contraindication, and CPT codes.

Exam/Procedure	Area of Concern	Common Reason(s)	Contrast	Study Type	CPT Code	Notes	hf:tax:original_sheet	hf:tax:area_concern	hf:tax:clinical_indication
Testicular ultrasound	Testicles	Epididymitis, Hydrocele, Orchalgia, Pain/swelling, Palpable lump, Torsion, Varicocele	N/A	Ultrasound	76870		ultrasound	testicles	epididymitis hydrocele orchalgia pain-swelling palpable-lump torsion varicocele
Chest – 4 or More Views, General X-ray	Chest, Chest and Lungs, Lungs, Ribs	Bone/Joint Injury or Issue, Chest pain, Fracture, Lung Function	N/A	X-Ray	71048		x-ray	chest chest-and-lungs lungs ribs	bone-joint-injury-or-issue chest-pain fracture lung-function
Abdominal ultrasound Complete	Abdomen	Abdominal pain (specify right or left upper quadrant or epigastric region), Abnormal LFT’s, Cirrhosis, Hepatitis C, Hepatomegaly, Polycystic disease, Splenomegaly	N/A	Ultrasound	76700		ultrasound	abdomen	abdominal-pain-specify-right-or-left-upper-quadrant-or-epigastric-region abnormal-lfts cirrhosis hepatitis-c hepatomegaly polycystic-disease splenomegaly
US Pelvis Transabdominal	Pelvis	Endometriosis, Fibroids / enlarged uterus, IUD, Menstrual disorders, Ovarian cysts, PCOS, Pelvic pain (relating specifically to uterus or ovaries; ultrasound is not the exam of choice for intestinal disorders)	N/A	Ultrasound	76830	Radiology Ltd.’s preferred protocol is to perform both the Transabdominal and Transvaginal scans as these will give the most detailed information. If only one study is preferred, our recommendation is to order a transvaginal scan.	ultrasound	pelvis	endometriosis fibroids-enlarged-uterus iud menstrual-disorders ovarian-cysts pcos pelvic-pain-relating-specifically-to-uterus-or-ovaries-ultrasound-is-not-the-exam-of-choice-for-intestinal-disorders
MRI chest without contrast	Chest	Pectoralis tear	No	MRI	71550	Without contrast. Chest Pectoralis. Specify right or left	mri	chest	pectoralis-tear
3D Diagnostic mammogram with tomosynthesis	Breast	3-6 month short term follow-up breast, 6 month follow up post breast biopsy (mammogram and/or ultrasound per radiologist report recommendation)	No	Mammography Diagnostic	77065 unilateral, 77066 bilateral	± breast ultrasound	mammography-diagnostic	breast	3-6-month-short-term-follow-up-breast 6-month-follow-up-post-breast-biopsy-mammogram-and-or-ultrasound-per-radiologist-report-recommendation
Foot ultrasound	Foot	Arthritis, Ganglion cyst/foreign body, Mortons Neuroma, Palpable abnormality, Plantar Fasciitis, Plantar plate tear, Tendinosis	N/A		76882	Specify left, right, or bilateral		foot	arthritis ganglion-cyst-foreign-body mortons-neuroma palpable-abnormality plantar-fasciitis plantar-plate-tear tendinosis
3D Screening mammogram with tomosynthesis	Breast	Screening Mamography	No	Mammography Screening	77063	Ultrasound if needed	mammography-screening	breast	screening-mamography
3D Screening mammogram with tomosynthesis	Breast	Mastectomy annual screening including CAD (unilateral)	No	Mammography Screening	77067-52	Unilateral. Ultrasound if needed.	mammography-screening	breast	mastectomy-annual-screening-including-cad-unilateral
3D Diagnostic mammogram with tomosynthesis	Breast	Personal history of breast cancer with lumpectomy	No	Mammography Diagnostic	77061 unilateral, 77062 bilateral	± breast ultrasound	mammography-diagnostic	breast	personal-history-of-breast-cancer-with-lumpectomy
3D Diagnostic mammogram with tomosynthesis and breast ultrasound	Breast	Breast Lump, Breast Mass, Nipple Discharge	No	Mammography Diagnostic	77061 unilateral, 77062 bilateral		mammography-diagnostic	breast	breast-lump breast-mass nipple-discharge
Additional mammogram views with breast ultrasound	Breast	Recommendation of additional imaging	No	Mammography Diagnostic	76642 - unilateral, 77065 unilateral, 77066 bilateral	± breast ultrasound Callback or Recall Exam	mammography-diagnostic	breast	recommendation-of-additional-imaging
3D Diagnostic mammogram with tomosynthesis and breast ultrasound	Breast	Breast Lump, Breast Mass, Nipple Discharge, Under 30 Years of age	No	Mammography Diagnostic	76642 - right or left	± 3D Diagnostic mammogram with tomosynthesis	mammography-diagnostic	breast	breast-lump breast-mass nipple-discharge under-30-years-of-age
CT Head/Brain	Brain	Alzheimer's, Confusion, CVA/Memory Loss, Headache, Hydrocephalus, Shunt check, Stroke/Bleed, Trauma	No	CT	70450	Without contrast Headache <7 days with possible trauma correlation	ct	brain	alzheimers confusion cva-memory-loss headache hydrocephalus shunt-check stroke-bleed trauma
CT Head/Brain	Brain	Headache, HIV, Infection/Mass/Tumor, Meningioma/Meningitis, Metastic staging, Migraine, Seizures, Toxoplasmosis, Vertigo/Dizziness/Mastoiditis	Yes	CT	70460	with contrast If patient has contraindication for MRI	ct	brain	headache hiv infection-mass-tumor meningioma-meningitis metastic-staging migraine seizures toxoplasmosis vertigo-dizziness-mastoiditis
CT Head/Brain	Pituitary	Hyperprolactinemia, Pituitary tumor	Yes	CT	70470	Without and with contrast	ct	pituitary	hyperprolactinemia pituitary-tumor
Shoulder Ultrasound	Shoulder	Arthritis, Bicep Tendon, Ganglion cyst/foreign body, Rotator cuff tear, Tendinosis/Tear	N/A	MRI	76882	Specify Left/Right/Bilateral	mri	shoulder	arthritis bicep-tendon ganglion-cyst-foreign-body rotator-cuff-tear tendinosis-tear
Elbow Ultrasound	Elbow	Arthritis, Biceps/Triceps Tendon Tear, Foreign Body, Ganglion cyst/foreign body, Neuropathy, Olecranon Bursitis, Palpable abnormality, Tendinosis, Ulnar/Median/Radial	N/A	MRI	76882	Specify Left/Right/Bilateral	mri	elbow	arthritis biceps-triceps-tendon-tear foreign-body ganglion-cyst-foreign-body neuropathy olecranon-bursitis palpable-abnormality tendinosis ulnar-median-radial
Hand/Wrist Ultrasound	Hands/Wrists	Arthritis, Ganglion cyst/foreign body, Palpable abnormality, Rheumatoid Arthritis, Tendinosis, Ulnar/Median/Radial	N/A	MRI	76882	Specify Left/Right/Bilateral	mri	hands-wrists	arthritis ganglion-cyst-foreign-body palpable-abnormality rheumatoid-arthritis tendinosis ulnar-median-radial
Knee Ultrasound		Arthritis, Baker Cyst, Ganglion cyst/foreign body, Palpable abnormality, Quadriceps/Patellar Tendinosis or Tear	N/A	MRI	76882	Specify Left/Right/Bilateral	mri		arthritis baker-cyst ganglion-cyst-foreign-body palpable-abnormality quadriceps-patellar-tendinosis-or-tear
Ankle Ultrasound	Ankle	Achilles Tendinosis or Tear, Arthritis, Ganglion cyst/foreign body, Palpable abnormality, Peroneals)	N/A	MRI	76882	Specify Left/Right/Bilateral	mri	ankle	achilles-tendinosis-or-tear arthritis ganglion-cyst-foreign-body palpable-abnormality peroneals
Pelvis Ultrasound	Male Pelvis	Bladder, Prostate, Seminal Vesicles	N/A	Ultrasound	76856		ultrasound	male-pelvis	bladder prostate seminal-vesicles
Pelvic Ultrasound Limited	Male or Female Pelvic Limited	Single Organ Evaluation	N/A	Ultrasound	76857		ultrasound	male-or-female-pelvic-limited	single-organ-evaluation
Bladder Ultrasound	Male Pelvis	Bladder Mass/Stone, Hematuria	N/A	Ultrasound	76857	Indicate if post-void residual is needed	ultrasound	male-pelvis	bladder-mass-stone hematuria
Renal Artery Duplex Ultrasound	Renal Artery	Abdominal Bruit, Renal Artery Stenosis Uncontrolled HTN	N/A	Ultrasound	93976		ultrasound	renal-artery	abdominal-bruit renal-artery-stenosis-uncontrolled-htn
Renal Ultrasound	Renals	Flank/Back Pain, Hematuria, Neurogenic Bladder, Polycystic Kidneys, Renal Cyst/Mass, Renal Disease (CKD), UTI	N/A	Ultrasound	76770		ultrasound	renals	flank-back-pain hematuria neurogenic-bladder polycystic-kidneys renal-cyst-mass renal-disease-ckd uti
Renal with Bladder Ultrasound	Renals and Bladder	Hematuria, Neurogenic Bladder, Polycystic Kidneys, Renal Cyst/Mass, Renal Disease (CKD)	N/A	Ultrasound	76770, 76857	This will assess kidneys/ bladder and postvoid residual	ultrasound	renals-and-bladder	hematuria neurogenic-bladder polycystic-kidneys renal-cyst-mass renal-disease-ckd
RUQ Abdominal Ultrasound	Abdomen RUQ	Abnormal LFT’s, Cirrhosis, Hepatitis C	N/A	Ultrasound	76705		ultrasound	abdomen-ruq	abnormal-lfts cirrhosis hepatitis-c
Soft Tissue Ultrasound	Abdominal Wall	Hernia's Ventral or Epigastric	N/A	Ultrasound	76705		ultrasound	abdominal-wall	hernias-ventral-or-epigastric
Soft Tissue Ultrasound	Arms	Bump, Cyst, Lipoma, Mass, Palpable lump	N/A	Ultrasound	Specify Exact Location	Specify Left/Right	ultrasound	arms	bump cyst lipoma mass palpable-lump
MRA Head	MRA Head	Aneurysm, AVM (Arteriovenous Malformation), CVA/TIA/Stroke, Insufficiency, Vascular Tumor Vertebrobasilar	No	MRI	70544	Without Contrast	mri	mra-head	aneurysm avm-arteriovenous-malformation cva-tia-stroke insufficiency vascular-tumor-vertebrobasilar
CT Temporal Bones/Inner Ears	Inner Ears	Cholesteotoma, Trauma	No	CT	70480	Without contrast	ct	inner-ear-s	cholesteotoma trauma
CT Temporal Bones/Inner Ears	Inner Ears	Endoscopic sinus surgery, Ostiomeatal complex, Sinusitis	Yes	CT	70481	With contrast	ct	inner-ear-s	endoscopic-sinus-surgery ostiomeatal-complex sinusitis
CT Orbits	Orbits/Eyes	Foreign Body, Fracture, Trauma	No	CT	70480	without contrast	ct	orbits-eyes	foreign-body fracture trauma
CT Orbits	Orbits/Eyes	Cellulitis/Mass, Exophthalmos, Graves’ disease, Pain	Yes	CT	70481	with contrast	ct	orbits-eyes	cellulitis-mass exophthalmos graves-disease pain
CT Sinus	Sinus	Endoscopic sinus surgery, Ostiomeatal complex, Sinusitis	No	CT	70486	without contrast	ct	sinus	endoscopic-sinus-surgery ostiomeatal-complex sinusitis
CT Sinus	Sinus	Mass or infection	Yes	CT	70487	With contrast	ct	sinus	mass-or-infection
CT Face	Facial Bones	Fracture	No	CT	70486	Without contrast	ct	facial-bones	fracture
CT Face	Facial Bones	Mass or infection	Yes	CT	70487	With contrast	ct	facial-bones	mass-or-infection
CT Mandible	Jaw/Mandible	Cyst, Mandible lesion	No	CT	70486	Without contrast	ct	jaw-mandible	cyst mandible-lesion
CT Soft Tissue Neck	Neck	Cancer/Metastatic Disease, Dysphagia, Infection, Lymphadenopathy, mass or stone of salivary gland (parotid or submandibular)	Yes	CT	70491	With contrast	ct	neck	cancer-metastatic-disease dysphagia infection lymphadenopathy mass-or-stone-of-salivary-gland-parotid-or-submandibular
CT Soft Tissue Neck	Thyroid	Parathyroid adenoma	Yes	CT	70492	Without and with contrast Please indicate (4D) Protocol	ct	thyroid	parathyroid-adenoma
CT Cervical Spine	Cervical Spine	Fracture, fusion, MR recommended for disc herniation, Trauma	No	CT	72125	Without contrast	ct	cervical-spine	fracture fusion mr-recommended-for-disc-herniation trauma
CT Cervical Spine	Cervical Spine	Abcess or infection, Metastatic disease	Yes	CT	72126	With contrast	ct	cervical-spine	abcess-or-infection metastatic-disease
CT Thoracic Spine	Thoracic Spine	Degenerative changes, Fracture, fusion, MR recommended for disc herniation, Trauma	No	CT	72128	Without contrast	ct	thoracic-spine	degenerative-changes fracture fusion mr-recommended-for-disc-herniation trauma
CT Thoracic Spine	Thoracic Spine	Abcess or infection, Metastatic disease	Yes	CT	72129	With contrast	ct	thoracic-spine	abcess-or-infection metastatic-disease
CT Lumbar Spine	Lumbar spine	Fracture, fusion, MR recommended for disc herniation, Pars defect, Trauma	No	CT	72131	Without contrast	ct	lumbar-spine	fracture fusion mr-recommended-for-disc-herniation pars-defect trauma
CT Lumbar Spine	Lumbar spine	Abcess or infection, Metastatic disease	Yes	CT	72132	With contrast	ct	lumbar-spine	abcess-or-infection metastatic-disease
CT Chest	Chest and Lungs	Asbestosis, Bronchiesctasis, Fibrosis, Interstitial lung disease, Pleural plaques, Sarcoidosis	No	CT	71250	Without contrast. Please indicate High Resolution	ct	chest-and-lungs	asbestosis bronchiesctasis fibrosis interstitial-lung-disease pleural-plaques sarcoidosis
CT Chest	Chest and Lungs	Abnormal chest X-ray, COPD/Cough, Hemoptysis, Lung/Esophageal CA, Lymphoma/Mass/Pain, Pneumonia, Shortness of breath, Tracheal stenosis	Yes	CT	71260	With contrast	ct	chest-and-lungs	abnormal-chest-x-ray copd-cough hemoptysis lung-esophageal-ca lymphoma-mass-pain pneumonia shortness-of-breath tracheal-stenosis
CT Chest	Lungs	Lung nodules	No	CT	71250	Without contrast	ct	lungs	lung-nodules
CT Heart	Heart Screening	Hyperlipidemia	No	CT	75571	Please indicate (Calcium Score)	ct	heart-screening	hyperlipidemia
CT Abdomen	Upper abdomen only	Abdominal pain, Hernia (ventral or umbilical)	No	CT	74150	Patient unable to have IV contrast	ct	upper-abdomen-only	abdominal-pain hernia-ventral-or-umbilical
CT Abdomen	Upper abdomen only	Abdominal pain, Abscess, Hernia (ventral or umbilical)	Yes	CT	74160	With contrast	ct	upper-abdomen-only	abdominal-pain abscess hernia-ventral-or-umbilical
CT Abdomen	Adrenals	Adrenal mass	Yes	CT	74170	Without and with contrast. Please indicate (Adrenal protocol).	ct	adrenals	adrenal-mass
CT Abdomen	Liver	Cirrhosis, Hepatitis, Hepatoma, Liver hemangioma (MR preferred)	Yes	CT	74170	Without and with contrast. Please indicate (Liver Protocol)	ct	liver	cirrhosis hepatitis hepatoma liver-hemangioma-mr-preferred
CT Abdomen	Pancreas	Pancreatic Mass, Pancreatitis, Pseudocyst	Yes	CT	74160	Without and with contrast. Please indicate (Pancreatic protocol).	ct	pancreas	pancreatic-mass pancreatitis pseudocyst
CT Abdomen	Kidneys	Any renal pathology	Yes	CT	74170	Without and with contrast. Please indicate (Renal protocol).	ct	kidneys	any-renal-pathology
CT Abdomen	Urinary/Renal system	Flank pain/Hematuria, Follow up hydronephrosis, Kidney Stone (renal calculi/stone), Post lithotripsy	No	CT	74176	Without contrast. Please indicate (Stone protocol).	ct	urinary-renal-system	flank-pain-hematuria follow-up-hydronephrosis renal-calculi-stone post-lithotripsy
CT Abdomen/Pelvis	Abdomen, Pelvis	Abdominal pain, Appendicitis, Cancer staging, Diarrhea, Diverticulitis, Infection	Yes	CT	74177	With contrast	ct	abdomen pelvis	abdominal-pain appendicitis cancer-staging diarrhea diverticulitis infection
CT Abdomen/Pelvis	Urinary/Renal system	Hematuria, Transitional cell carcinoma of kidney and/or bladder	Yes	CT	74178	Without and with contrast. Please indicate (IVP/Urogram Protocol).	ct	urinary-renal-system	hematuria transitional-cell-carcinoma-of-kidney-and-or-bladder
CT Abdomen/Pelvis	Small Intestine	Abscess/Inflammation, Bleeding sources, Bowel obstruction, Crohn's disease, Small bowel related issues, Tumor/Fistula	Yes	CT	74177	With contrast Please indicate (Enterography Protocol)	ct	small-intestine	abscess-inflammation bleeding-sources bowel-obstruction crohns-disease small-bowel-related-issues tumor-fistula
CT Abdomen/Pelvis	Colon	Failed colonoscopy, Patients on blood thinners who are not candidates for routine colonoscopy, Screening	No	CT	74261 Diagnostic, 74263 Screening	Without contrast and 3D rendering. Please indicate (Virtual Colonography).	ct	colon	failed-colonoscopy patients-on-blood-thinners-who-are-not-candidates-for-routine-colonoscopy screening
CT Pelvis	Pelvis	Arthritis, Fracture, Inguinal hernia	No	CT	72192	Without contrast.	ct	pelvis	arthritis fracture inguinal-hernia
CT Pelvis	Pelvis	Bone infection, Cancer staging, Hernia (inguinal), Pain/Mass/Cysts, Pelvic Infection	Yes	CT	72193	With contrast.	ct	pelvis	bone-infection cancer-staging hernia-inguinal pain-mass-cysts pelvic-infection
CT Cystogram	Pelvis and Bladder	Bladder Cancer, Bladder polyps, Fistula/Bleeding, Hydronephrosis, Vesicoureteral reflux	No	CT	51600, 72192	With contrast.	ct	pelvis-and-bladder	bladder-cancer bladder-polyps fistula-bleeding hydronephrosis vesicoureteral-reflux
CTA Brain	Brain	Aneurysm, AVM (Arteriovenous Malformation), CVA/TIA/Stroke, Vascular Tumor	Yes	CT	70496	With contrast.	ct	brain	aneurysm avm-arteriovenous-malformation cva-tia-stroke vascular-tumor
CTV Brain	Brain	AVM (Arteriovenous Malformation)	Yes	CT	70460	With contrast.	ct	brain	avm-arteriovenous-malformation
CTA Carotids	Carotid Arteries	Bruit, Cartoid stenosis, CVA/TIA/Stroke, Vascular Tumor, Vertebrobasilar Insufficiency	Yes	CT	70498	With contrast.	ct	carotid-arteries	bruit cartoid-stenosis cva-tia-stroke vascular-tumor vertebrobasilar-insufficiency
CTA Head/Neck	Brain, Carotid Arteries	Vertebrobasilar Insufficiency	Yes	CT	70496, 70498	With contrast.	ct	brain carotid-arteries	vertebrobasilar-insufficiency
CTA Upper Extremities	Arms	Arterial stenosis, Ischemia	Yes	CT	73206	With contrast (Indicate Right or Left and area of concern)	ct	arms	arterial-stenosis ischemia
CTA Chest	Pulmonary Arteries	Pulmonary embolism, Shortness of breath	Yes	CT	71275	With contrast. Please indicate (PE Protocol).	ct	pulmonary-arteries	pulmonary-embolism shortness-of-breath
CTA Chest	Aorta	Aortic dissection, Thoracic aortic aneurysm	Yes	CT	71275	With contrast. Please indicate (Aorta Protocol).	ct	aorta	aortic-dissection thoracic-aortic-aneurysm
CTA Chest	Subclavian Arteries	Stenosis	Yes	CT	71275	With contrast (Please indicate Subclavian Protocol)	ct	subclavian-arteries	stenosis
CTA Chest and Abdomen	Aorta	Aortic dissection, Thoracic aortic aneurysm	Yes	CT	71275, 74175	With contrast	ct	aorta	aortic-dissection thoracic-aortic-aneurysm
CTA Mesenteric Arteries	Mesenteric arteries	Mesenteric ischemia	Yes	CT	74175	With contrast	ct	mesenteric-arteries	mesenteric-ischemia
CTA Renal Arteries	Renal Artery	Hypertension, Renal artery stenosis	Yes	CT	74175	With contrast	ct	renal-artery	hypertension renal-artery-stenosis
CTA abdomen and pelvis	Aorta & Iliacs	AAA/Stent Graft, Stent graft obstruction/Leak/Malfunction	Yes	CT	74147	With contrast	ct	aorta-iliacs	aaa-stent-graft stent-graft-obstruction-leak-malfunction
CTA Abdomen/Pelvis and bilateral runoff	Aorta & Iliacs, Distal arteries, Femoral	Claudication, Non healing wound, Peripheral artery disease	Yes	CT	75635	With contrast	ct	aorta-iliacs distal-arteries femoral	claudication non-healing-wound peripheral-artery-disease
CTA Pelvis	Iliac Arteries	AVM, Iliac aneurysm	Yes	CT	72191	With contrast	ct	iliac-arteries	avm iliac-aneurysm
CTV Pelvis	Pelvic veins	DVT, Pelvic congestion	Yes	CT	72193	With contrast	ct	pelvic-veins	dvt pelvic-congestion
CTA Lower Extremities	Distal arteries, Femoral, Iliac Arteries	Claudication, Ischemia, Non healing wound, Peripheral artery disease	Yes	CT	73706	With contrast	ct	distal-arteries femoral iliac-arteries	claudication ischemia non-healing-wound peripheral-artery-disease
CT Sternoclavicular Joints	Sternoclavicular Joints	Swelling	No	CT	71250	Without contrast	ct	sternoclavicular-joints	swelling
CT Upper Extremities	Elbow, Forearms, Hands/Wrists, Humerus, Shoulder	*MR Preferred, DJD, Fracture, Surgical planning	No	CT	73200	Without contrast	ct	elbow forearms hands-wrists humerus shoulder	mr-preferred djd fracture surgical-planning
CT Upper Extremities	Elbow, Forearms, Hands/Wrists, Humerus, Shoulder	*MR Preferred, Cancer/Metastatic Disease, Infection, Mass, Tumor	Yes	CT	73201	With contrast	ct	elbow forearms hands-wrists humerus shoulder	mr-preferred cancer-metastatic-disease infection mass tumor
CT Lower Extremities	Ankle, Femurs, Foot, Hips, Knees, Tibia/Fibula	*MR Preferred, DJD, Fracture, Surgical planning	No	CT	73700	Without contrast	ct	ankle femurs foot hips knees tib-fib	mr-preferred djd fracture surgical-planning
CT Lower Extremities	Ankle, Femurs, Foot, Hips, Knees, Tibia/Fibula	*MR Preferred, Cancer/Metastatic Disease, Infection, Mass, Tumor	Yes	CT	73701	With contrast	ct	ankle femurs foot hips knees tib-fib	mr-preferred cancer-metastatic-disease infection mass tumor
MRI Brain	Brain	Alzheimer's, Confusion, Dementia, Headache, Hydrocephalus, Memory loss, Mental status changes, Migraine	No	MRI	70551	Without contrast.	mri	brain	alzheimers confusion dementia headache hydrocephalus memory-loss mental-status-changes migraine
MRI Brain	Brain	Cancer, Headache (pseudotumor), Mass, Mets, Seizures, Tumor, Vascular lesions	Yes	MRI	70553	Without and with contrast	mri	brain	cancer headache-pseudotumor mass mets seizures tumor vascular-lesions
MRI Brain	Brain	Metabolic abnormality Demyelinating disease	Yes	MRI	70553, 76390	Without and with contrast	mri	brain	metabolic-abnormality-demyelinating-disease
MRI Brain	Pituitary	Hyperprolactinemia, Pituitary tumor	Yes	MRI	70553	Without and with contrast. Please indicate (Pituitary protocol).	mri	pituitary	hyperprolactinemia pituitary-tumor
MRI Brain	Brain (IAC) Ears	Hearing loss	Yes	MRI	70553	Without and with contrast	mri	brain-iac-ears	hearing-loss
MRI Brain	Brain	Dementia, Memory loss, Seizures	No	MRI	70551, 76377	Without contrast to include NeuroQuant (3D volumetric analysis)	mri	brain	dementia memory-loss seizures
MRI brain and orbits	Brain, Face, Orbits/Eyes	Exophthalmos, Graves’ disease, Proptosis	Yes	MRI	70543, 70553	Without and with contrast	mri	brain face orbits-eyes	exophthalmos graves-disease proptosis
MRI Brain	Cranial nerves	Bell’s palsy, Trigeminal neuralgia	Yes	MRI	70553	Without and with contrast. Please indicate (Cranial nerves).	mri	cranial-nerves	bells-palsy trigeminal-neuralgia
MRI TMJ	TMJ	Internal derangement, Joint dysfunction	No	MRI	70336	Without contrast	mri	tmj	internal-derangement joint-dysfunction
MRI neck	Neck (soft tissue)	Cancer, Infection, Mass, Mets, Tumor, Vocal cord paralysis	Yes	MRI	70543	Without and with contrast	mri	neck-soft-tissue	cancer infection mass mets tumor vocal-cord-paralysis
MRI cervical spine	Cervical Spine	Arm pain and/or weakness, Chiari malformation, Degenerative disease, Disc herniation, Neck Pain, Post-op fusion radiculopathy	No	MRI	72141	Without contrast	mri	cervical-spine	arm-pain-and-or-weakness chiari-malformation degenerative-disease disc-herniation disc-herniation-neck-pain post-op-fusion-radiculopathy
MRI cervical spine	Cervical Spine	AVM, Cancer, Discitis/Osteomyelitis, Mass, Mets, Multiple sclerosis, Myelopathy/Syrinx, Tumor, Vascular lesions	Yes	MRI	72156	Without and with contrast	mri	cervical-spine	avm cancer discitis-osteomyelitis mass mets multiple-sclerosis myelopathy-syrinx tumor vascular-lesions
MRI thoracic spine	Spine, Thoracic Spine	Back pain/Trauma, Compression fractures, Degenerative disease, Disc herniation, Radiculopathy, Vertebroplasty Planning (with history of malignancy/mets)	No	MRI	72146	Without contrast	mri	spine thoracic-spine	back-pain-trauma compression-fractures degenerative-disease disc-herniation radiculopathy vertebroplasty-planning
MRI thoracic spine	Spine, Thoracic Spine	AVM, Cancer, Compression fractures, Discitis/Myelopathy, Mass, Mets, Multiple sclerosis, Osteomyelitis/Syrinx, Tumor, Vascular lesions, Vertebroplasty Planning (with history of malignancy/mets)	Yes	MRI	72157	Without and with contrast	mri	spine thoracic-spine	avm cancer compression-fractures discitis-myelopathy mass mets multiple-sclerosis osteomyelitis-syrinx tumor vascular-lesions vertebroplasty-planning
MRI lumbar spine	Lumbar spine	Back pain/Sciatica/Trauma, Compression fractures, Degenerative disease, Disc herniation, Radiculopathy, Spondylolisthesis/Stenosis, Vertebroplasty Planning (with history of malignancy/mets)	No	MRI	72148	Without contrast	mri	lumbar-spine	back-pain-sciatica-trauma compression-fractures degenerative-disease disc-herniation radiculopathy spondylolisthesis-stenosis vertebroplasty-planning
MRI lumbar spine	Lumbar spine	Cancer, Compression fractures, Discitis/Osteomyelitis, Mass, Mets, Post-op, Tumor, Vertebroplasty, Vertebroplasty Planning (with history of malignancy/mets)	Yes	MRI	72158	Without and with contrast	mri	lumbar-spine	cancer compression-fractures discitis-osteomyelitis mass mets post-op tumor vertebroplasty vertebroplasty-planning
MRI Breast	Breast	Suspected silicone implant leak	Yes	MRI	77049	(bilateral) (Implant protocol)	mri	breast	suspected-silicone-implant-leak
MRI Breast	Breast	High risk breast cancer screening	Yes	MRI	77049	(bilateral)	mri	breast	high-risk-breast-cancer-screening
MRI Breast	Breast	Follow-up for neo-adjuvant chemotherapy treatment	Yes	MRI	77049	(bilateral)	mri	breast	follow-up-for-neo-adjuvant-chemotherapy-treatment
MRI Breast	Breast	Further evaluation for indeterminate clinical or imaging results (radiologist recommendation)	Yes	MRI	77049	(bilateral)	mri	breast	further-evaluation-for-indeterminate-clinical-or-imaging-results-radiologist-recommendation
MRI chest	Chest Mediastinum	Cancer, Mass, Mets, Tumor	Yes	MRI	71552	Without and with contrast	mri	chest-mediastinum	cancer mass mets tumor
MRI heart	Heart	Congenital defect, Heart valve issues, Past MI - other cardiac issues	Yes	MRI	75557, 75561		mri	heart	congenital-defect heart-valve-issues past-mi-other-cardiac-issues
MRI Chest/Mediastinum	Brachial Plexus	Brachial plexus injury, Cancer, Mass, Mets, Nerve avulsion, Tumor	Yes	MRI	71552	Without and with contrast (specify brachial plexus)	mri	brachial-plexus	brachial-plexus-injury cancer mass mets nerve-avulsion tumor
MRI enterography	Small Intestine	Crohn's disease, Inflammatory bowel disease	Yes	MRI	72197, 74183	Without and with contrast	mri	small-intestine	crohns-disease inflammatory-bowel-disease
MRI abdomen	Pancreas	Adrenals, MRCP (biliary / pancreatic ducts)	No	MRI	74183	Without contrast (MRCP)	mri	pancreas	adrenals mrcp
MRA abdomen	Renal Mesenteric Arteries	AAA (Abdominal aortic aneurysm), Abdominal aorta dissection, Mesenteric ischemia, Renal artery stenosis	Yes	MRI	74185	With contrast	mri	renal-mesenteric-arteries	aaa-abdominal-aortic-aneurysm abdominal-aorta-dissection mesenteric-ischemia renal-artery-stenosis
MRI abdomen	Abdomen	All other reasons, Kidney eval, Liver eval, Pancreas eval	Yes	MRI	74183	Without and with contrast	mri	abdomen	all-other-reasons kidney-eval liver-eval pancreas-eval
MRI pelvis	Pelvis	Arthritis, Fracture, Muscle/Tendon tear	No	MRI	72195	Without contrast	mri	pelvis	arthritis fracture muscle-tendon-tear
Pelvis	Pelvis	Abscess/Adenomyosis, Cancer staging, Cyst, Fibroid/Osteomyelitis, Inguinal hernia, Mass, Mets, Pain, Pelvic, Pelvic/Bone Infection, Pre/Post fibroid embolization, Septic arthritis, Tumor, Urethral diverticulum	Yes	MRI	72197	Without and with contrast	mri	pelvis	abscess-adenomyosis cancer-staging cyst fibroid-osteomyelitis inguinal-hernia mass mets pain pelvic pelvic-bone-infection pre-post-fibroid-embolization septic-arthritis tumor urethral-diverticulum
MRI dynamic pelvis	Pelvis	Incontinence, Outlet obstruction, Pelvic floor dysfunction, Pelvic organ prolapse	Yes	MRI	72195	Without contrast	mri	pelvis	incontinence outlet-obstruction pelvic-floor-dysfunction pelvic-organ-prolapse
MRI urogram	Urogram	Congenital abnormalities, Hematuria, Urinary tract obstruction	Yes	MRI	72197, 74183	Without and with contrast	mri	urogram	congenital-abnormalities hematuria urinary-tract-obstruction
MR pelvis	Prostate	Benign prostatic hyperplasia (BPH), Enlarged prostate, Evaluation of prostate cancer, Infection (prostatitis), Prostate abscess	Yes	MRI	72197, 76377	Without and with contrast and 3D	mri	prostate	benign-prostatic-hyperplasia-bph enlarged-prostate evaluation-of-prostate-cancer infection-prostatitis prostate-abscess
MRA Carotids/Neck	MRA Carotid/Neck	Bruit, Cartoid stenosis, Dissection	Yes	MRI	70458	With contrast	mri	mra-carotid-neck	bruit cartoid-stenosis dissection
MRV Brain	Brain		N/A	MRI	70544	Without contrast	mri	brain
MRI chest	Scapula	Mass, Pain	Yes	MRI	71552	Without and with. Contrast Indicate Right or Left.	mri	scapula	mass pain
MRI Upper extremity (non joint)	Arms, Finger, Hand	Cancer, Infection, Mass, Metastatic disease, Tumor	Yes	MRI	73220	Without contrast Indicate. Right or Left and body part.	mri	arms finger hand	cancer infection mass metastatic-disease tumor
MRI Upper extremity (joint)	Elbow, Shoulder, Wrist	Articular cartilage injury, Avascular necrosis (AVN), Internal derangement, Joint pain (specify joint), Labral, Ligament or tendon tear, Muscle strain, Osteochondritis dissecans (OCD), Stress fracture/Fracture, Tendinosis	Yes	MRI	73221	Without contrast. Indicate Right or Left and body part.	mri	elbow shoulder wrist	articular-cartilage-injury avascular-necrosis-avn internal-derangement joint-pain-specify-joint labral ligament-or-tendon-tear muscle-strain osteochondritis-dissecans-ocd stress-fracture-fracture tendinosis
MRI Upper extremity (non joint)	Arms, Finger, Hand	Fracture, Muscle/Tendon tear, Stress Fracture	No	MRI	73218	Without contrast Indicate Right or Left and body part	mri	arms finger hand	fracture muscle-tendon-tear stress-fracture
MRI Upper extremity (joint)	Elbow, Shoulder, Wrist	Cancer, Infection, Mass, Metastatic disease, Tumor	Yes	MRI	73223	Without and with contrast. Indicate Right or Left and body part.	mri	elbow shoulder wrist	cancer infection mass metastatic-disease tumor
MRI Lower extremity	Foot, Leg	Fracture, Muscle/Tendon tear, Stress Fracture	No	MRI	73718	Without contrast. Indicate Right or Left and body part.	mri	foot leg	fracture muscle-tendon-tear stress-fracture
MRI Lower extremity (non joint)	Foot, Leg	Cancer, Infection, Mass, Metastatic disease, Tumor	Yes	MRI	73720	Without and with contrast. Indicate Right or Left and body part.	mri	foot leg	cancer infection mass metastatic-disease tumor
MRI Lower extremity (joint)	Ankle, Hips, Knees, Toe	Cancer, Infection, Mass, Metastatic disease, Tumor	No	MRI	73723	Without and with contrast. Indicate Right or Left and body part.	mri	ankle hips knees toe	cancer infection mass metastatic-disease tumor
MRI Lower extremity (joint)	Ankle, Hips, Knees, Toe	Articular cartilage injury, Avascular necrosis (AVN), Internal derangement, Joint pain (specify joint), meniscal or tendon tear, Muscle strain, Osteochondritis dissecans (OCD), Plantar Fasciitis, Stress fracture/Fracture, Tendinosis	Yes	MRI	73721	Without contrast. Indicate Right or Left and body part.	mri	ankle hips knees toe	articular-cartilage-injury avascular-necrosis-avn internal-derangement joint-pain-specify-joint meniscal-or-tendon-tear muscle-strain osteochondritis-dissecans-ocd plantar-fasciitis stress-fracture-fracture tendinosis
MRI Coccyx, MRI Sacrum, MRI SI joints	Sacrum/Coccyx or SI Joints	Arthritis, Fracture	No	MRI	72195	Without contrast	mri	sacrum-coccyx-or-si-joints	arthritis fracture
MRI Coccyx, MRI Sacrum, MRI SI joints	Sacrum/Coccyx or SI Joints	Metastatic disease, Sacroilitis	Yes	MRI	72196	With contrast	mri	sacrum-coccyx-or-si-joints	metastatic-disease sacroilitis
MRI Breast (Bilateral), MRI Chest (If needed)	Breast	Recent diagnosis of breast cancer (pre-operative staging)	Yes	MRI	71552, 77049		mri	breast	recent-diagnosis-of-breast-cancer-pre-operative-staging
MRA abdomen, MRI abdomen	Liver or Renal Transplant	Pre-kidney transplant, Pre-liver transplant, Renal mass-evaluation/Pre-op	Yes	MRI	74183, 74185	MRA abdomen without contrast & MRI abdomen without and with contrast	mri	liver-or-renal-transplant	pre-kidney-transplant pre-liver-transplant renal-mass-evaluation-pre-op
MRA Head, MRA Neck	MRA Head, MRA Neck	Bruit, Cartoid stenosis, CVA/TIA/Stroke, Dissection, Vertebrobasilar Insufficiency	Yes	MRI	70544, 70548	MRA Head without contrast & MRA Neck with contrast	mri	mra-head mra-neck	bruit cartoid-stenosis cva-tia-stroke dissection vertebrobasilar-insufficiency
Fluoroscopic guided Arthrogram MRI Upper extremity (joint)	Shoulder	Labral tear, Loose bodies, Osteochondritis dissecans (OCD), TFCC/Tear scapholunate ligament	Yes	MRI	23350, 73040, 73222, 77002, Shoulder	With contrast. Indicate Right/Left or bilateral.	mri	shoulder	labral-tear loose-bodies osteochondritis-dissecans-ocd tfcc-tear-scapholunate-ligament
Fluoroscopic guided Arthrogram MRI Upper extremity (joint)	Elbow	Labral tear, Loose bodies, Osteochondritis dissecans (OCD), TFCC/Tear scapholunate ligament	Yes	MRI	23350, 73040, 73222, 77002, Wrist	With contrast. Indicate Right/Left or bilateral.	mri	elbow	labral-tear loose-bodies osteochondritis-dissecans-ocd tfcc-tear-scapholunate-ligament
Arthrogram MRI Upper extremity (joint)	Wrist	Labral tear, Loose bodies, Osteochondritis dissecans (OCD), TFCC/Tear scapholunate ligament	Yes	MRI	25246, 73115, 73222, 77002, Wrist	With contrast. Indicate Right/Left or bilateral.	mri	wrist	labral-tear loose-bodies osteochondritis-dissecans-ocd tfcc-tear-scapholunate-ligament
Fluoroscopic guided Arthrogram MRI lower extremity (joint)	Hips	Labral tear, Loose bodies, Osteochondritis dissecans (OCD), Post-op meniscus evaluation	Yes	MRI	27093, 27095, 73525, 73722, Hip	With contrast. Indicate Right/Left or bilateral.	mri	hips	labral-tear loose-bodies osteochondritis-dissecans-ocd post-op-meniscus-evaluation
Fluoroscopic guided Arthrogram MRI lower extremity (joint)	Knees	Labral tear, Loose bodies, Osteochondritis dissecans (OCD), Post-op meniscus evaluation	Yes	MRI	27369, 73580, 73722, 77002, Knee	With contrast. Indicate Right/Left or bilateral.	mri	knees	labral-tear loose-bodies osteochondritis-dissecans-ocd post-op-meniscus-evaluation
Fluoroscopic guided Arthrogram MRI lower extremity (joint)	Ankle	Labral tear, Loose bodies, Osteochondritis dissecans (OCD), Post-op meniscus evaluation	Yes	MRI	27648, 73615, 73722, 77002, Ankle	With contrast. Indicate Right/Left or bilateral.	mri	ankle	labral-tear loose-bodies osteochondritis-dissecans-ocd post-op-meniscus-evaluation
PET / CT Whole Body	Whole Body	Cutaneous Lymphoma, Melanoma, Merkel cell carcinoma, Myeloma, Sarcoma	N/A	PET	78816		pet	whole-body	cutaneous-lymphoma melanoma merkel-cell-carcinoma myeloma sarcoma
PET / CT Vertex to Mid-Thigh	Vertex (Top of Head) to Mid-Thigh	All other types of cancer	N/A	PET	78815		pet	vertex-top-of-head-to-mid-thigh	all-other-types-of-cancer
PET / CT Vertex to Mid-Thigh	Vertex (Top of Head) to Mid-Thigh	Metastatic disease of brain	N/A	PET	78608		pet	vertex-top-of-head-to-mid-thigh	metastatic-disease-of-brain
PET / CT Vertex to Mid-Thigh	Vertex (Top of Head) to Mid-Thigh	Myocardium (Cannot do if patient is diabetic)	N/A	PET	78459		pet	vertex-top-of-head-to-mid-thigh	myocardium-cannot-do-if-patient-is-diabetic
PET / CT Bone Scan	Whole Body	Metastatic bone cancer lesions or disease (Sodium fluoride PET bone scans are not covered by insurance)	N/A	PET	78816		pet	whole-body	metastatic-bone-cancer-lesions-or-disease-sodium-fluoride-pet-bone-scans-are-not-covered-by-insurance
PET / CT Vertex to Mid-Thigh	Vertex (Top of Head) to Mid-Thigh	Prostate cancer post treatments & rising PSA	N/A	PET	78815		pet	vertex-top-of-head-to-mid-thigh	prostate-cancer-post-treatments-rising-psa
PET / CT Vertex to Mid-Thigh	Vertex (Top of Head) to Mid-Thigh	Neuroendocrine tumors	N/A	PET	78815		pet	vertex-top-of-head-to-mid-thigh	neuroendocrine-tumors
DEXA	Hips and Spine Bones	Early surgical menopause, Follow-up treatment for prevention/monitoring of osteoporosis, Long-term current use of other medication, Long-term current use of steroid treatment, Post menopause, Vertebral abnormalities	No	DEXA	77080, Hip, Spine (axial skeleton)		dexa	hips-and-spine-bones	early-surgical-menopause follow-up-treatment-for-prevention-monitoring-of-osteoporosis long-term-current-use-of-other-medication long-term-current-use-of-steroid-treatment post-menopause vertebral-abnormalities
DEXA + VFA	Hips and Spine Bones	Vertebral fracture assessment and DEXA	No	DEXA	77085		dexa	hips-and-spine-bones	vertebral-fracture-assessment-and-dexa
DEXA (VFA)	Hips and Spine Bones	Vertebral fracture assessment only	No	DEXA	77086		dexa	hips-and-spine-bones	vertebral-fracture-assessment-only
DEXA (BCS)	Hips and Spine Bones	Body composition study	No	DEXA	76499		dexa	hips-and-spine-bones	body-composition-study
Bilateral breast MRI (and chest MRI if necessary)	Breast	Pre-operative staging	No	MRI	77049		mri	breast	pre-operative-staging
Bilateral breast MRI “Implant protocol”	Breast	Silicone breast implants	No	MRI	77049		mri	breast	silicone-breast-implants
Bilateral breast MRI	Breast	Follow-up for chemotherapy treatment, High risk breast cancer screening, Radiologist recommendation	No	MRI	77049		mri	breast	follow-up-for-chemotherapy-treatment high-risk-breast-cancer-screening radiologist-recommendation
Ultrasound Bilateral Carotid Duplex	Carotid Arteries	Amaurosis fugax, Arterial vascular disease, Ataxia HTN, Hyperlipidemia, Stenosis, Stroke, TIA	N/A	Ultrasound	93880		ultrasound	carotid-arteries	amaurosis-fugax arterial-vascular-disease ataxia-htn hyperlipidemia stenosis stroke tia
Ultrasound Thyroid	Thyroid	Enlarged thyroid/Fullness, Goiter, Hypo-/Hyper-thyroid, Nodules, Thyroiditis	N/A	Ultrasound	76536		ultrasound	thyroid	enlarged-thyroid-fullness goiter hypo-hyper-thyroid nodules thyroiditis
Ultrasound Soft tissue face, Ultrasound Soft tissue head, Ultrasound Soft tissue neck, Ultrasound Soft tissue scalp	Face, Head, Neck, Scalp	Bump, Cyst, Lipoma, Mass, Palpable lump	N/A	Ultrasound	76536	Indicate which area	ultrasound	face head neck scalp	bump cyst lipoma mass palpable-lump
Upper Extremity Venous Duplex/Doppler	Upper extremity vasculature	Deep vein thrombosis, Redness, Upper extremity Swelling/Pain	N/A	Ultrasound	93970, 93971, Bilat, Unilat	(Specify Left/ Right or Bilateral with indication for each)	ultrasound	upper-extremity-vasculature	deep-vein-thrombosis redness upper-extremity-swelling-pain
	Shoulder	Arthritis, Bicep Tendon, Foreign Body, Ganglion cyst, Rotator cuff tear, Tendinosis/Tear	N/A	Ultrasound	Not Listed Explicitly - Ask Client	Specify Left/Right/Bilateral	ultrasound	shoulder	arthritis bicep-tendon foreign-body ganglion-cyst rotator-cuff-tear tendinosis-tear
Abdominal duplex ultrasound	Liver	Liver transplant, Portal HTN, Portal venous thrombosis, TIPS	N/A	Ultrasound	93975		ultrasound	liver	liver-transplant portal-htn portal-venous-thrombosis tips
Screening Aorta Ultrasound Medicare Screening	Aorta		N/A	Ultrasound	76706		ultrasound	aorta
Aorta duplex Ultrasound	Aorta & Iliacs	AAA (Abdominal aortic aneurysm), Abdominal bruit/Pulsitile mass, Aortic dissection	N/A	Ultrasound	93978	Not screening AAA for Medicare	ultrasound	aorta-iliacs	aaa-abdominal-aortic-aneurysm abdominal-bruit-pulsitile-mass aortic-dissection
US Pelvis Complete Transabdominal & Transvaginal	Female Pelvic	Endometriosis, Fibroids / enlarged uterus, IUD, Menstrual disorders, Ovarian cysts, PCOS, Pelvic pain (relating specifically to uterus or ovaries; ultrasound is not the exam of choice for intestinal disorders)	N/A	Ultrasound	76856		ultrasound	female-pelvic	endometriosis fibroids-enlarged-uterus iud menstrual-disorders ovarian-cysts pcos pelvic-pain-relating-specifically-to-uterus-or-ovaries-ultrasound-is-not-the-exam-of-choice-for-intestinal-disorders
	Groin, Pelvic wall	Inguinal hernia	N/A	Ultrasound	76857, 76882		ultrasound	groin pelvic-wall	inguinal-hernia
Lower extremity Venous Duplex/Doppler	Lower extremity vasculature	Deep vein thrombosis, Redness, Upper extremity Swelling/Pain	N/A	Ultrasound	93970, 93971, Bilat, Unilat	(Specify Left/ Right or Bilateral with indication for each)	ultrasound	lower-extremity-vasculature	deep-vein-thrombosis redness upper-extremity-swelling-pain
Soft Tissue Ultrasound	Leg	Bump, Cyst, Lipoma, Mass, Palpable lump	N/A	Ultrasound	Specify Exact Location	Specify Left/ Right	ultrasound	leg	bump cyst lipoma mass palpable-lump
Knee Ultrasound	Knees	Arthritis, Baker Cyst, Foreign Body, Ganglion cyst, Palpable abnormality, Quadriceps/Patellar Tendinosis or Tear	N/A	Ultrasound	76882	Specify Left/Right/Bilateral	ultrasound	knees	arthritis baker-cyst foreign-body ganglion-cyst palpable-abnormality quadriceps-patellar-tendinosis-or-tear
Venous Duplex/Doppler	Venous Doppler Upper or Lower Extremity For extremity lumps and bumps see Soft Tissue Ultrasound	Deep vein thrombosis, Redness, Swelling/Pain, Upper and Lower Extremity	N/A	Ultrasound	93970, 93971, Bilat, Unilat	(specify upper or lower and bilateral, right, or left with indication for each)	ultrasound	venous-doppler-upper-or-lower-extremity-for-extremity-lumps-and-bumps-see-soft-tissue-ultrasound	deep-vein-thrombosis redness swelling-pain upper-and-lower-extremity
General X-ray			N/A	X-Ray	70250		x-ray
General X-ray, Skull Minimum 4 Views	Head	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	70260		x-ray	head	bone-joint-injury-or-issue fracture
General X-ray, Orbits Minimum 4 Views	Orbits/Eyes	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	70200		x-ray	orbits-eyes	bone-joint-injury-or-issue fracture
General X-ray, Sinuses Paranasal < 3 Views	Nose, Sinus	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	70210		x-ray	nose sinus	bone-joint-injury-or-issue fracture
General X-ray, Sinuses Paranasal Minimum 3 Views	Nose, Sinus	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	70220		x-ray	nose sinus	bone-joint-injury-or-issue fracture
General X-ray, Screening Orbits (Pre-MRI)	Orbits/Eyes	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	70030		x-ray	orbits-eyes	bone-joint-injury-or-issue fracture
Facial Bones < 3 Views, General X-ray	Facial Bones	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	70140		x-ray	facial-bones	bone-joint-injury-or-issue fracture
Facial Bones Minimum 3 Views, General X-ray	Facial Bones	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	70150		x-ray	facial-bones	bone-joint-injury-or-issue fracture
General X-ray, Nasal Bones Minimum 3 Views	Nose	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	70160		x-ray	nose	bone-joint-injury-or-issue fracture
General X-ray, Mandible < 4 Views	Mandible	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	70100		x-ray	mandible-4-views-2	bone-joint-injury-or-issue fracture
General X-ray, Mandible 4 Views	Mandible	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	70110		x-ray	mandible-4-views-2	bone-joint-injury-or-issue fracture
General X-ray	Neck Soft Tissue (Not for Cervical Spine)		N/A	X-Ray	70360		x-ray	neck-soft-tissue-not-for-cervical-spine
C-Spine 2 or 3 Views, General X-ray	Cervical Spine	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	72040		x-ray	cervical-spine	bone-joint-injury-or-issue fracture
C-Spine Minimum 4-5 Views, General X-ray	Cervical Spine	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	72050		x-ray	cervical-spine	bone-joint-injury-or-issue fracture
C-Spine Complete 6 or More Views, General X-ray	Cervical Spine	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	72052		x-ray	cervical-spine	bone-joint-injury-or-issue fracture
General X-ray, T-Spine 2 Views	Spine, Thoracic Spine	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	72070		x-ray	spine thoracic-spine	bone-joint-injury-or-issue fracture
General X-ray, T-Spine 3 Views	Spine, Thoracic Spine	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	72072		x-ray	spine thoracic-spine	bone-joint-injury-or-issue fracture
General X-ray, T-Spine 4 Views	Spine, Thoracic Spine	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	72074		x-ray	spine thoracic-spine	bone-joint-injury-or-issue fracture
General X-ray, L/S-Spine 2 or 3 Views	Lumbar spine	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	72100		x-ray	lumbar-spine	bone-joint-injury-or-issue fracture
General X-ray, L/S-Spine Minimum 4 Views	Lumbar spine	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	72110		x-ray	lumbar-spine	bone-joint-injury-or-issue fracture
General X-ray, L/S-Spine Complete with Bending Views (Minimum 6 Views)	Lumbar spine	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	72114		x-ray	lumbar-spine	bone-joint-injury-or-issue fracture
General X-ray, L/S-Spine Bending Views ( Only 2-3 Views)	Lumbar spine	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	72120		x-ray	lumbar-spine	bone-joint-injury-or-issue fracture
General X-ray, Thoracolumbar Junction (Minimum 2 Views)	Sacrum/Coccyx or SI Joints, Thoracic Spine	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	72080		x-ray	sacrum-coccyx-or-si-joints thoracic-spine	bone-joint-injury-or-issue fracture
General X-ray, Spine - Entire Thoracic and Lumbar, including Skull, Cervical and Sacral (if performed) - 1 View	Head, Neck, Spine		N/A	X-Ray	72081		x-ray	head neck spine
General X-ray, Spine - Entire Thoracic and Lumbar, including Skull, Cervical and Sacral (if performed) - 2 or 3 Views	Cervical Spine, Head, Lumbar spine, Spine, Thoracic Spine	Bone/Joint Injury or Issue, Fracture, Scoliosis Evaluation	N/A	X-Ray	72082		x-ray	cervical-spine head lumbar-spine spine thoracic-spine	bone-joint-injury-or-issue fracture scoliosis-evaluation
General X-ray, Spine - Entire Thoracic and Lumbar, including Skull, Cervical and Sacral (if performed) - 4 or 5 Views	Cervical Spine, Head, Lumbar spine, Neck, Spine, Thoracic Spine	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	72083		x-ray	cervical-spine head lumbar-spine neck spine thoracic-spine	bone-joint-injury-or-issue fracture
General X-ray, Spine – Entire Thoracic and Lumbar, including Skull, Cervical and Sacral (if performed) – Minimum 6 Views	Cervical Spine, Head, Lumbar spine, Spine, Thoracic Spine	Bone/Joint Injury or Issue, Fracture, Scoliosis Evaluation	N/A	X-Ray	72084		x-ray	cervical-spine head lumbar-spine spine thoracic-spine	bone-joint-injury-or-issue fracture scoliosis-evaluation
Chest - 1 View, General X-ray	Chest, Chest and Lungs, Lungs, Ribs	Bone/Joint Injury or Issue, Fracture, Lung Function	N/A	X-Ray	71045		x-ray	chest chest-and-lungs lungs ribs	bone-joint-injury-or-issue fracture lung-function
Chest - 2 Views, General X-ray	Chest, Chest and Lungs, Lungs, Ribs	Bone/Joint Injury or Issue, Fracture, Lung Function, Lung nodules	N/A	X-Ray	71046		x-ray	chest chest-and-lungs lungs ribs	bone-joint-injury-or-issue fracture lung-function lung-nodules
Chest - 3 Views, General X-ray	Chest, Chest and Lungs, Lungs, Ribs	Bone/Joint Injury or Issue, Fracture, Lung Function, Lung nodules	N/A	X-Ray	71047		x-ray	chest chest-and-lungs lungs ribs	bone-joint-injury-or-issue fracture lung-function lung-nodules
General X-ray, Ribs Bilateral 3 Views	Ribs	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	71110		x-ray	ribs	bone-joint-injury-or-issue fracture
General X-ray, Ribs Unilateral 2 Views	Ribs	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	71100		x-ray	ribs	bone-joint-injury-or-issue fracture
General X-ray, Ribs Unilateral 2 Views with Chest 1 View	Ribs	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	71101		x-ray	ribs	bone-joint-injury-or-issue fracture
General X-ray, Sternum Minimum 2 Views	Sternoclavicular Joints		N/A	X-Ray	71120		x-ray	sternoclavicular-joints
General X-ray, Sternoclavicular Joints 3 Views	Sternoclavicular Joints	Bone/Joint Injury or Issue, Dislocation, Fracture	N/A	X-Ray	71130		x-ray	sternoclavicular-joints	bone-joint-injury-or-issue dislocation fracture
General X-ray, Shoulder 2 Views	Shoulder	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73030		x-ray	shoulder	bone-joint-injury-or-issue fracture
General X-ray, Shoulder 1 View	Shoulder	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73020		x-ray	shoulder	bone-joint-injury-or-issue fracture
Acromioclavicular Joints Bilateral, General X-ray	Acromioclavicular Joints Bilateral, Upper Extremities	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73050		x-ray	acromioclavicular-joints-bilateral upper-extremities	bone-joint-injury-or-issue fracture
Clavicle Complete, General X-ray	Collar Bone	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73000		x-ray	collar-bone	bone-joint-injury-or-issue fracture
General X-ray, Scapula Complete	Scapula, Shoulder	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73010		x-ray	scapula shoulder	bone-joint-injury-or-issue fracture
General X-ray, Humerus Minimum 2 Views	Arms	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73060		x-ray	arms	bone-joint-injury-or-issue fracture
Elbow Minimum 3 Views, General X-ray	Elbow	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73080		x-ray	elbow	bone-joint-injury-or-issue fracture
Elbow 2 Views, General X-ray	Elbow	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73070		x-ray	elbow	bone-joint-injury-or-issue fracture
Forearm 2 Views, General X-ray	Forearms	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73090		x-ray	forearms	bone-joint-injury-or-issue fracture
General X-ray, Wrist 2 Views	Wrist	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73100		x-ray	wrist	bone-joint-injury-or-issue fracture
General X-ray, Hand 2 Views	Hand	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73120		x-ray	hand	bone-joint-injury-or-issue fracture
Finger(s) Minimum 2 Views, General X-ray	Finger	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73140		x-ray	finger	bone-joint-injury-or-issue fracture
General X-ray	Upper Extremity Infant (up to 364 days old) Minimum 2 Views		N/A	X-Ray	73092		x-ray	upper-extremity-infant-up-to-364-days-old-minimum-2-views
Abdomen 1 View, General X-ray	Abdomen	Abdominal pain	N/A	X-Ray	74018		x-ray	abdomen	abdominal-pain
Abdomen 2 Views, General X-ray	Abdomen	Abdominal pain	N/A	X-Ray	74019		x-ray	abdomen	abdominal-pain
Abdomen 3 or More Views, General X-ray	Abdomen	Abdominal pain	N/A	X-Ray	74021		x-ray	abdomen	abdominal-pain
Acute Abdomen Series + PA CXR 3 Views, General X-ray	Abdomen	Abdominal pain	N/A	X-Ray	74022		x-ray	abdomen	abdominal-pain
General X-ray, Pelvis 1 or 2 Views	Hips, Pelvis	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	72170		x-ray	hips pelvis	bone-joint-injury-or-issue fracture
General X-ray, Pelvis Minimum 3 Views	Hips, Pelvis	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	72190		x-ray	hips pelvis	bone-joint-injury-or-issue fracture
General X-ray, Hip, Unilateral, with Pelvis - 1 View	Hips, Pelvis	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73501		x-ray	hips pelvis	bone-joint-injury-or-issue fracture
General X-ray, Hip, Unilateral, with Pelvis - 2 or 3 Views	Hips, Pelvis	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73502		x-ray	hips pelvis	bone-joint-injury-or-issue fracture
General X-ray, Hips, Unilateral, with Pelvis - Minimum 4 Views	Hips, Pelvis	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73503		x-ray	hips pelvis	bone-joint-injury-or-issue fracture
General X-ray, Hips, Bilateral, with Pelvis – 2 Views	Hips, Pelvis		N/A	X-Ray	73521		x-ray	hips pelvis
General X-ray, Hips, Bilateral, with Pelvis - Minimum 3-4 Views	Hips, Pelvis	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73522		x-ray	hips pelvis	bone-joint-injury-or-issue fracture
General X-ray, Hips, Bilateral, with Pelvis - Minimum 5 Views	Hips, Pelvis	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73523		x-ray	hips pelvis	bone-joint-injury-or-issue fracture
General X-ray, Sacrum & Coccyx Minimum 2 Views	Sacrum/Coccyx or SI Joints	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	72220		x-ray	sacrum-coccyx-or-si-joints	bone-joint-injury-or-issue fracture
General X-ray, Sacroiliac Joints 3+ Views	Hips	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	72202		x-ray	hips	bone-joint-injury-or-issue fracture
Femur - 1 View, General X-ray	Femurs		N/A	X-Ray	73551		x-ray	femurs
Femur – 2 Views Minimum, General X-ray	Femurs	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73552		x-ray	femurs	bone-joint-injury-or-issue fracture
General X-ray, Knee 1 or 2 Views	Knees	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73560		x-ray	knees	bone-joint-injury-or-issue fracture
General X-ray, Knee 3 Views	Knees	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73562		x-ray	knees	bone-joint-injury-or-issue fracture
General X-ray, Knee 4 or More Views	Knees	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73564		x-ray	knees	bone-joint-injury-or-issue fracture
Both Knees Standing AP, General X-ray	Knees	Bone/Joint Injury or Issue, Fracture, Joint dysfunction, Joint pain (specify joint)	N/A	X-Ray	73565		x-ray	knees	bone-joint-injury-or-issue fracture joint-dysfunction joint-pain-specify-joint
General X-ray, Tibia & Fibula 2 Views	Tibia/Fibula	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73590		x-ray	tib-fib	bone-joint-injury-or-issue fracture
Ankle 2 Views, General X-ray	Ankle	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73600		x-ray	ankle	bone-joint-injury-or-issue fracture
Ankle Minimum 3 Views, General X-ray	Ankle	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73610		x-ray	ankle	bone-joint-injury-or-issue fracture
Foot Minimum 3 Views, General X-ray	Foot	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73630		x-ray	foot	bone-joint-injury-or-issue fracture
Calcaneus (Heel) Minimum 2 Views, General X-ray	Foot, Heel	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73650		x-ray	foot heel	bone-joint-injury-or-issue fracture
General X-ray, Toe(s) Minimum 2 Views	Toe	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73660		x-ray	toe	bone-joint-injury-or-issue fracture
General X-ray	Lower Extremity Infant (up to 364 days old) 2+ Views		N/A	X-Ray	73592		x-ray	lower-extremity-infant-up-to-364-days-old-2-views
Bone Age Studies, General X-ray	Bone Age	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	77072		x-ray	bone-age-studies	bone-joint-injury-or-issue fracture
Bone Length Studies, General X-ray	Bone Length	Bone/Joint Injury or Issue	N/A	X-Ray	77073		x-ray	bone-length-studies	bone-joint-injury-or-issue
General X-ray	Osseous Complete (Bone Survey)		N/A	X-Ray	77075		x-ray	osseous-complete-bone-survey
Not Listed Explicitly - Ask Client	Renal Artery	Not Listed Explicitly - Ask Client	N/A	Ultrasound	93976, Duplex, Limited, Scan		ultrasound	renal-artery	not-listed-explicitly-ask-client
	Aorta	AAA (Abdominal aortic aneurysm)	N/A	Ultrasound	76706	AAA screening per Medicare	ultrasound	aorta	aaa-abdominal-aortic-aneurysm
MRA Head, MRA Neck	MRA Head and MRA Neck	Bruit, Cartoid stenosis, CVA/TIA/Stroke, Dissection, Vertebrobasilar Insufficiency	Yes	MRI	70544, 70548	MRA Head without contrast. MRA Neck with contrast.	mri	mra-head-and-mra-neck	bruit cartoid-stenosis cva-tia-stroke dissection vertebrobasilar-insufficiency
CT Chest lung cancer screening	Lungs	Lung cancer screening (must meet criteria)	No	CT	71271 (*71250 - for short term followup exams of 3 or 6 month only)	Without contrast	ct	lungs	lung-cancer-screening-must-meet-criteria
Breast Biopsy (Right or Left)	Breast	Indeterminate Breast Lesion/s	No	Breast Procedures (Diagnostic)	Additional lesion - 19082, Additional lesion - 19084, MRI guided biopsy - 19085, Stereotactic guided biopsy - 19081, Ultrasound guided biopsy - 19083	Right or Left	breast-procedures	breast	indeterminate-breast-lesion-s
Cystic Aspiration of the right or left breast	Breast	Cystic mass or lesion(s)	No	Breast Procedures (Diagnostic)	19000, 19001 x number of additional cysts 76942, Multiple same side, Ultrasound guided single 19000, Ultrasound guided single 76942		breast-procedures	breast	cystic-mass-or-lesion-s
Foot 2 Views, General X-ray	Foot	Bone/Joint Injury or Issue, Fracture	N/A	X-Ray	73620		x-ray	foot	bone-joint-injury-or-issue fracture