Radiology Prior Authorization CPT Code List ...

1 Radiology | Prior AuthorizationPCA-1-22-01799-VC-WEB_05262 022-POCPT codeDescriptionModality70450CT HEAD/BRN C-MATRLCT70460CT HEAD/BRN C+ MATRLCT70470CT HEAD/BRN C-/C+CT70480CT ORBIT SELLA/POST FOSSA/EAR C-MATRLCT70481CT ORBIT SELLA/POST FOSSA/EAR C+ M AT RLCT70482CT ORBIT SELLA/POST FOSSA/EAR C-/C+CT70486CT MAXLFCL AREA C-MATRLCT70487CT MAXLFCL AREA C+ MATRLCT70488CT MAXLFCL AREA C-/C+CT70490CT SOFT TISS NCK C-MATRLCT70491CT SOFT TISS NCK C+ MATRLCT70492CT SOFT TISS NCK C-/C+CT70496CT ANGIOGRAPHY HEAD W/CONTRAST/ NONCONTRASTCT70498CT ANGIOGRAPHY NECK W/CONTRAST/ NONCONTRASTCT71250CT THORAX C-MATRLCT71260CT THORAX C+ MATRLCT71270CT THORAX C-/C+CT71275CT ANGIOGRAPHY CHEST W/CONTRAST/ NONCONTRASTCT72125CT CRV SPI C-MATRLCT72126CT CRV SPI C+ MATRLCT72127CT CRV SPI C-/C+CT72128CT THRC SPI C-MATRLCT72129CT THRC SPI C+ MATRLCT72130CT THRC SPI C-/C+CT72131CT LMBR SPI C-MATRLCT72132CT LMBR SPI C+ MATRLCT72133CT LMBR SPI C-/C+CTUnitedHealthcare Community Plan Radiology Prior Authorization CPT code listThe table below contains the CPT and Healthcare Common Procedure Coding System codes that apply to our UnitedHealthcare

76380 ct lmtd/loclzd f-up std ct 76497 unlis ct px ct g02971 ct thorax c-matrl low dose ct s8092 electron beam computed tomography (also known as ultrafast ct, cinet) ct 0501t ffr-ct (global) ct 0502t ffr-ct (data prep & trans) ct 0503t ffr-ct (vendor tech component) ct 0504t ffr-ct (inter & report – md) ct 70336 mri tmprmand jt mr

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