CPT Codes 2017 - SDMI

1 Abdomen without74150 Cervical62302 Abdomen / MRCP 74181 Abdomen with 74160 Thoracic62303 Abdomen / MRCP with & without74183 Abdomen with & without74170 Lumbar62304 Abdomen / Pelvis without74176 MRA Abdomen74185 Abdomen / Pelvis with 74177 MRA Brain70544 Abdomen / Pelvis with & without74178 MRA Carotid / Neck70547 Abdomen with & without Pelvis with 74178 MRA Chest71555 CTA Abdomen with & without74175 CTA Abdomen Runoff (to toes)75635 MRA Pelvis Without72198 CTA Abdomen / Pelvis74174 CTA Cardiac75574 Brain without70551 CTA Chest with & without71275 Brain with & without70553 CTA Coronary75574 CTA Head with & without70496 CTA Neck with & without70498 CTA Pelvis with & without72191 Cervical without72125 Thoracic without72128 Cardiac75557 Lumbar without72131 Cervical without72141 Chest without71250 Cervical with & without72156 Chest with 71260 Thoracic without 72146 Chest with & without71270 Thoracic with & without72157 Chest PE Protocol71275 Lumbar without 72148 Lumbar with & without72158 Facial Bones without70486 Hip73721 Head without70450 Head with 70460 Head with & without70470 Axial Skeleton77080 Plus Vertebral Lower Extremity without73700 FractureONLY Vertebral

2 Orbits without70480 FractureOrbits without70540 Orbits with 70481 Orbits with & without70482 Pelvis without 72195 Pelvis with & without72197 Pelvis without72192 Pelvis with Neck without 70540 Pelvis with & Neck with & Neck Neck with Neck with & without70492 Sinus without70486 Temp Bones / IAC's without70480 Upper Extremity without73200 Urogram74178 CTMRICT MyelogramThumbHip73722 73580 273702017 CPT Codes MR/CTWrist (3 compartment)623052 or more Regions73222 73115 2524673219 77002 20600 Brain & Orbits with & withoutMRA Pelvis Runoff (to ankle)70553 705437322173222 73040 23350 KneeShoulder 77059 .0159 TUpper Extremity - JointSpecify: Shoulder, Elbow, Wrist77086 Page 1 of 3 Updated 1/31/1519085 19086 Breast BiopsyAdditional LesionWrist (1 compartment)AnkleLower Extremity - JointSpecify: Hip, Knee, Ankle73721 Upper Extremity - Not a Joint Specify: Humerus, Forearm, Hand73218 MRI Arthrogram (joint contrast)DexascanLower Extremity - Not a Joint Specify.

3 Femur, TibFib, Foot7371873725x2 7219873722 73525 27093 Breast Bilateral without or with & withoutDX=cander add7708573722 73615 27648 73222 73115 25246xBarium Swallow74220 Abdominal Complete76700 Abdominal Limited76705 Aorta Iliac IVC for Aneurysm76705 Barium Enema74270 Breast (Bilateral x2)76641 Barium Enema with Air74280 Carotid93880 Chest76604 Doppler, Arterial Bilateral Lower93925 Doppler, Arterial Unilateral Lower 93926 Doppler, Arterial Bilateral Upper93930 Doppler, Arterial Unilateral Upper 93931 Doppler, Mesenteric93976 Doppler Renal Artery93975 Doppler, Portal Vein93976 Doppler, Venous Bilateral93970 Doppler, Venous Unilateral93971 Small Bowel Follow Through74250 Fetal Hips76885 Upper with KUB74247 Head / Soft Tissue Neck76536OB Single >14wks76805OB Multiple76810OB 1st Trimester < 14 wks76801OB T-Vag76817 Liver Spleen78215 Pelvis76856 Renal76770 Renal Post Transplant76776 Scrotal (Testicular)76870 Thoracentesis32555 Thyroid76536 Transrectal (Prostate)

4 76872 Additional LesionTransvaginal76830 Thyroid Uptake and Scan 780142017 CPT CODESNM/Fluoro/Mammo/USThyroid BiopsySpecify: Side, NoduleUltrasound Guided ProceduresUpper withSmall Bowel Series7424976942 19000 Breast Cyst AspirationSpecify: Side, Nodule20611U/S Pain Mgmt - Lg Joint Specify: Hip Right or Left49083 99070 ParacentesisBreast BiopsyPage 2 of 3 Updated 1/31/1577002 20605 Pain Mgmt - Int Joint Specify: Ankle, Wrist, Elbow77002 20610 Pain Mgmt - Lg Joint Specify: Hip Right or Left2060676856 76830 Pelvis with T-Vag76831 58340 99070 HSGPain Mgmt - Int JointSpecify: Ankle, Wrist, ElbowModified Barium Swallow (must have speech pathologist)74230 Hysterosalpinogram74740 58340 Upper Barium SwallowVCUG76942 99070 1002277051 G0206-5219083 G0206 77051 A4550 19084 74455 5160077052 G020220610 7700274247 74220 Ultrasound93978 Doppler Aorta IliacIVC for TransplantPain Mgmt - Sm JointSpecify: Toes, FingersPain Mgmt - Hip Injection Fluoroscopy Diagnostic Bilateral77051 G020476880 Pain Mgmt - Sm JointSpecify: Toes, Fingers2060477051 G020677052 G0202-52 ExtremitySpecify.

5 Body PartA9521 78805 WBC LimitedA9562 78708 Renal CaptoprilA9521 78806 WBC Whole BodyMuga ScanScreening BilateralScreening UnilateralA9560 78472 Mag / Spot UnilateralA9517 79005 78018 Digital MammographyAll I-131 Addt'l Info on Pg 4A9567 A9540 78598 71020 Lung VQ A9562 78708 Renal LasixA9551 78710 Renal Scan-DMSAR enal Mag 3A9541 78205 Liver Spect ScanA9500 78070 Parathyroid ScanA9562 78708J1245 A9502 A9505 78227 Hida with CCKA9517 79005 I-131 TherapyA9537 78226 Hida without CCKA9528 78018I-131 Whole Body ScanI-131 Whole Body Scanwith TherapyA9541 78264 Gastric EmptyingA9502 A9505 78452 Heart TreadmillJ1245 A9502 A9505 78452 Heart PharmacologicNuclear MedicineA9503 78306A9503 78300 Bone Scan Whole BodyBone Scan LimitedSpecify: Body PartBone SpectA9503 78315 Bone Scan 3 Phase Specify: Body PartA9503 7832020206 76942 99070 Soft Tissue Neck Biopsy Specify.

6 Side, Nodule19081 19082 Stereotactic Breast Biopsy Additional Lesion77003 62270 Lumbar Puncture77002 20600 Diagnostic Unilateral77051 G0204-52 Mag / Spot Bilateral for Nuclear MedicineTHYROGEN I131 WHOLE BODY SCAN NO HIGH DOSE*Thyrogen given by doctor s office Monday and Tuesday *SDMI Dose Wednesday*SDMI Whole Body Scan Friday-I131 WHOLE BODY SCAN WITH HIGH DOSE ( MCI-200 MCI)*TSH>30 Pregnancy test Required within 7 days unless Hysterectomy/Tubal Ligation *SDMI High Dose *SDMI Whole Body Scan 1 week after High DoseTHYROGEN I131 WHOLE BODY SCAN WITH HIGH DOSE ( MCI-200 MCI) *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 Dose7801278014A9517 78018A9517 78018 2017 CPT CODES78014I131 WHOLE BODY SCAN-NO THYROGEN NO HIGH DOSE*TSH >30*SDMI Dose *SDMI Whole Body ScanPage 3 of 3 Updated 1/31/1579005 7801879005 78018 THYROID UPTAKE SINGLE DETERMINATION * Probe only with one return (2, 4, 6, OR 24 HOURS)

7 THYROID IMAGING, WITH UPTAKE-SINGLE DETERMINATION* Return with probe plus one image of the thyroid gland acquired at 6 hours after doseTHYROID IMAGING WITH UPTAKE-MULTIPLE DETERMINATIONS * Return with probe and Includes the above with two returns for determination Additional Gui