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CT ORDERING GUIDE

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.

Transitional Cell Carcinoma of Kidney Renal Mass (Cyst vs. Solid) Yes Yes CT ABDOMEN AND PELVIS W & WO CONTRAST 74170 and 72193 Adrenal Adrenal Mass Water Yes CT ABDOMEN W & W/O CONTRAST 74170 Pancreas Pancreatic Mass Pancreatitis Water Yes CT ABDOMEN W & W/O CONTRAST 74170 Bladder Tumor staging and follow up

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  Bladder, Cells, Transitional, Transitional cell

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