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CT ORDERING GUIDE

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CT ORDERING GUIDE . Body Part Reason for exam Oral IV contrast Procedure to pre-cert CPT code prep Chest/Thorax General Chest Chest Pain Shortness of Breath None Yes CTA CHEST W IV 71275. Pulmonary Emboli Pneumonia None Yes CT THORAX/CHEST W IV 71260. Cough Lung Nodule None None CT THORAX/CHEST W/O 71250. CONTRAST. Cancer restaging Cancer Restaging (any cancer) None Yes CT THORAX/CHEST W IV 71260. Chest mass Esophageal Cancer Oral Hi Resolution Interstitial Disease CT THORAX/CHEST W/O. Fibrosis None None CONTRAST - Please specify Hi 71250. Bronchiectasis resolution protocol only COPD/Emphysema Hemoptysis CT THORAX/CHEST W IV - Please Sarcoidosis None Yes specify additional series with Hi 71260. resolution reconstructions Abdomen/ General Abdominal Pain Pelvis Mass Yes Yes CT ABDOMEN & PELVIS W 74160.

None None SPINE CERVICAL W/O CONTRAST THORACIC SPINE W/O CONTRAST LUMBAR SPINE W/O CONTRAST 72125 or 72128 or 72131 Infectio n Mass (If MRI contraindicated) None Yes CERVICAL SPINE W/CONTRAST THORACIC SPINE W/CONTRAST LUMBAR SPINE W/CONTRAST 72126 or 72129 or 72132 Pelvis/Hips/ Acetabulum Pain Fracture Arthritis None …

  Spine, Cervical, Cervical spine

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