Transcription of CT ORDERING GUIDE
1 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.
2 Resolution reconstructions abdomen / General Abdominal Pain pelvis Mass Yes Yes CT abdomen & pelvis W 74160. All Cancer Staging CONTRAST and (Except melanoma 72193. or carcinoid). Cancer Staging Yes Yes CT abdomen AND pelvis W & 74170. Melanoma and WO CONTRAST and Carcinoid 72193. Gastrointestinal Crohns Disease Ulcerative Colitis IBD. Appendicitis Yes Yes CT abdomen & pelvis W 74160. Diverticulitis CONTRAST and Abscess 72193. Hernia (ventral, umbilical, inguinal). Obstruction Colon Protocol Yes Yes CT abdomen & pelvis W 74160. (Colon Cancer, poly, Rectal CONTRAST (Please order with and post surgical) contrast Rectal Contrast) 72193.
3 Liver Post Embolization Hemangioma Yes Yes CT abdomen W & W/O 74170. Hepatoma CONTRAST. Hepatitis Cirrhosis Renal Stone Study None None CT abdomen pelvis W/O 74150 and CONTRAST 72192. Hematuria painless Transitional Cell Yes Yes CT abdomen AND pelvis W & 74170. Carcinoma of Kidney WO CONTRAST and Renal Mass (Cyst vs. 72193. Solid). Adrenal Adrenal Mass Water Yes CT abdomen W & W/O 74170. CONTRAST. Pancreas Pancreatic Mass Water Yes CT abdomen W & W/O 74170. Pancreatitis CONTRAST. Bladder Tumor staging and Water Yes CT abdomen & pelvis W 74160 and follow up CONTRAST 72193.
4 Body Part Reason for exam Oral IV contrast Procedure to pre-cert CPT code prep CT Abdominal Aorta Aneurysm (diagnosis Angiography and surgical planning) Water or Yes CTA abdomen W IV 74175. Mesenteric ischemia None Renal artery stenosis Aorta Dissection CT CHEST, abdomen AND 71250, Intramural None Yes pelvis WITHOUT + 74150, hematoma CTA CHEST W IV AND CTA 72192. Complicated abdomen W IV (Please order 71275 and aneurysm both exams) 74175. Chest pain Pulmonary Pulmonary embolism arteries Pulmonary None Yes CTA CHEST W IV 71275. hypertension Hemoptysis Lower Peripheral Artery None Yes CTA pelvis W/RUNOFFS 75635.
5 Extremities Disease Musculoskeletal Upper and Pain None None Lower Arthritis CT EXTREMITY UPPER W/O 73200 or Extremities Fracture BONE ROUT OR EXT LOWER W/O 73700. Fusion CONTRAST. Malunion Upper and Infection None Yes CT EXT UPPER W/IV OR EXT 73201 or Lower Tumor/mass/cancer LOWER W/CONTRAST 73701. Extremities Spine Pain None None SPINE CERVICAL W/O CONTRAST 72125 or Fracture THORACIC SPINE W/O 72128 or Trauma CONTRAST 72131. Fusion LUMBAR SPINE W/O CONTRAST. Infection None Yes CERVICAL SPINE W/CONTRAST 72126 or Mass THORACIC SPINE W/CONTRAST 72129 or (If MRI LUMBAR SPINE W/CONTRAST 72132.)
6 Contraindicated). pelvis /Hips/ Pain None None Acetabulum Fracture CT pelvis W/O CONTRAST 72192. Arthritis Tumor None Yes CT pelvis W/IV CONTRAST 72193. Infectio
