MRI NUCLEAR MEDICINE MAMMOGRAPHY PET Full-Service, …

1 CPT List Reformatted 1 3/23/2015. 3:16:06 PM 1 1/18/2018 2:33:18 PM. PET/CT CT/CTA MRI/MRA BONE DENSITY NUCLEAR MEDICINE . DIGITAL MAMMOGRAPHY ECHOCARDIOGRAPHY DIGITAL XRAY. ULTRASOUND VASCULAR STUDIES RADIATION ONCOLOGY IMRT. VASCULAR & INTERVENTIONAL CENTER. MRI. MRI. NUCLEAR . NuclearMEDICINE. MEDICINE MRI PET CT. MAMMOGRAPHY . MAMMOGRAPHY PETM edicine NUCLEAR PET. Full-Service, All Digital Imaging Network MAMMOGRAPHY CT. CT. west covina ONTARIO POMONA. DIAGNOSTIC RADIOLOGY CPT GUIDE 2018. X-RAY ULTRASOUND. BONE & JOINTS HEAD/NECK. Bone Age Studies 77072 Soft tissues of Head & Neck (Thyroid, Parathyroid, Parotid) 76536. Bone Length Studies (Scanogram/ Orthoroentgenogram) 77073 BREAST. Bone Survey - Skeletal 77075 Breast Complete (Unilateral) 76641. ABDOMEN 1v 2v 3v 4v+ Breast Limited (Unilateral) 76642. Abdomen AP and Add'l Oblique and Cone Views 74010 74019 74021 74021 CHEST. Abdomen Complete Acute Abdomen Series 70422 Chest for Pleural Effusion, Fluid and/ or Masses in Chest Wall 76604.

2 Abdomen Complete Incl. Decubitus & Erect Views 74020 74019 74021 74021 ABDOMEN. Abdomen, AP, Single View KUB 74018 Abdomen (Complete) 76700. HEAD, NECK & OROFACIAL BONES 1v 2v 3v 4v+ Abdomen (Ltd) 1 Org/Quad; F/U; Inguinal Hern; R/O Hern; Groin P 76705. Facial Bones 70140 70150 KIDNEY/RENAL. Mandible 70100 70110 Kidney/Renal Complete; Retroperitoneal 76770. Mastoids 70120 70130 PELVIS. Nasal Bones 70160 Pelvic Limited (Non OB); Inguinal Hern; R/O Hern; Groin Pain 76857. Sinuses/ Paranasal 70210 70220 Pelvic Complete (Non Obstetric) 76856. Skull 70250 70260 Transvaginal (Non Obstetric) 76830. Neck, Soft Tissue 70360 GENITALIA (MALE). Orbits 70200 Prostate (Non-Transrectal) 76856. Temporomandibular Joint, Open/Closed, Bilateral 70330 Scrotum and Contents (Testicles) 76870. CHEST 1v 2v 3v 4v+ OBSTERICAL. Chest 71045 71046 71048 OB (1st Trimester <14 Weeks 0 days) 76801. Chest, 2 Views w/ Apical Lordotic Procedure 71047 OB (2nd & 3rd Trimester > or = 14 Weeks 0 Days) 76805.

3 Chest, 2 Views w/ Oblique Projections 71047 71048 OB Limited (Fetal Heartbeat, Placental & Fetal Position) 76815. Chest Special Views 71035 71046 71048 OB Transvaginal 76817. C. Clavicle Complete 73000 OB Follow Up (Re-Evaluate Fetal Size & Organ Sys.) 76816. M. Ribs, Unilateral 71100 71101 SOFT TISSUE. Ribs, Bilateral 71110 71111 Exam of Upper & Lower Extremities (Complete) 76881. Y Sternum 71120 71130 Exam of Upper & Lower Extremities (Limited) 76882. SPINE 1v 2v 3v 4v+ Axilla 76882. CM Cervical Spine **(6 or more views use CPT 72052) 72040 72050 Chest Wall (Limited) 76604-52. Cervical Spine Complete, Incl Oblique; Flex & Ext 72052 Pelvic Wall (Retroperitoneal Region, Penis, Perinum) 76857. MY. Lumbosacral, AP & Lateral 72100 72100 72110 Buttock 76857. CY. Lumbosacral, Bending Views Only 72120 72120 Groin (Hip Groin Region & Peripheral Nerves) 76882. Lumbosacral, Complete Incl. Bending Views 72114 Other Soft Tissue 76999.

4 CMY Sacrum & Coccyx 72220 INFANTS. Sacroiliac Joints 72200 72202 Infant Hips Dynamic (w/ Physician Manipulation) 76885. K Spine, Scoliosis Study, Incl. Supine & Erect **(6 or more 72081 72082 72082 72083 SPINE. views use CPT 72084) Spinal Canal & Contents 76800. Spine, Single View, Specify Level (Scoliosis) 72020 VASCULAR ULTRASOUND DUPLEX/DOPPLER. Thoracic 72070 72072 72074 VENOUS REFLUX EXTREMITY. Thoracolumbar Junction 72080 Duplex extremity veins - Complete Bilateral 93970. SHOULDER, UPPER ARM & ELBOW 1v 2v 3v 4v+ Duplex extremity veins - Limited/ Unilateral 93971. Acromioclavicular Joint Bilat w/ or w/o Weights 73050 ARTERIAL EXTREMITY. Elbow 73070 73080 Duplex Lower Extremities Arteries Complete Bilateral 93925. Humerus 73060 Duplex Lower Extremity Arteries Limited/ Unilateral 93926. Scapula Complete 73010 Duplex Upper Extremities Arteries Complete Bilateral 93930. Shoulder 73020 73030 Duplex Upper Extremity Arteries Limited/ Unilateral 93931.

5 FOREARM, HAND & FINGERS 1v 2v 3v 4v+ ABI 93922. Fingers 73140 CAROTID. Forearm 73090 Duplex Extracranial Arteries Complete Bilateral 93880. Hand 73120 73130 AORTA. Wrist 73100 73110 Abdominal/ Aorta - Screening AAA 76706. LOWER LEG, KNEE, ANKLE & FOOT 1v 2v 3v 4v+ KIDNEY/ RENAL. Calcaneus or Heel 73650 Renal Arterial Complete 93975. Foot 73620 73630 DIGITAL MAMMOGRAPHY . Ankle 73600 73610 CHEST. Tibia & Fibula 73590 Screening, Bilateral; All Views (formerly G0202) 77067. Toe(s) 73660 Diagnostic, Bilateral; All Views (formerly G0204) 77066. Knee 73560 73560 73562 73564 Diagnostic, Unilateral; All Views (formerly G0206) 77065. Knee, Both, Standing AP 73565 Spot Compression, Bilateral (formerly G0204) 77066. PELVIC REGION, HIP & THIGH 1v 2v 3v 4v+ Spot Compression, Unilateral (formerly G0206) 77065. Femur 73551 73552 Implants (formerly G0204) 77066. Hip Unilateral, Incl. AP of Pelvis 73501 73502 73502 73503 DEXA (BONE DENSITOMETRY).

6 Hip Bilateral, Incl. AP of Pelvis **(5 v+ use CPT 73523) 73521 73522 73522 Dual-Energy X-Ray (DEXA) 77080. Pelvis 72170 72170 ECHOCARDIOGRAPHY. Echocardiography; Transthoracic, Complete 93306. Rev 01162018 Copyright | Centrelake 2018. 10226 Lakewood Blvd, Downey, CA 90241. 1700 W. West Covina Pkwy, West Covina, CA 91790 (909) 242-7300 (626) 773-7717 (562) 287-7200. 3115 E. Guasti Road, Ontario, CA 91761. 1555 N. Orange Grove Ave, Pomona, CA 91767 Scheduling Fax (909) 784-3760. 1183 E. Foothill Blvd, Ste 235, Upland, CA 91786 1433 N. Hollenbeck Ave, Ste 105, Covina, CA 91722. CPT List Reformatted 1 3/23/2015. 3:16:06 PM 1 1/18/2018 2:36:17 PM. PET/CT CT/CTA MRI/MRA BONE DENSITY NUCLEAR MEDICINE . DIGITAL MAMMOGRAPHY ECHOCARDIOGRAPHY DIGITAL XRAY. ULTRASOUND VASCULAR STUDIES RADIATION ONCOLOGY IMRT. VASCULAR & INTERVENTIONAL CENTER. MRI. MRI. NUCLEAR . NuclearMEDICINE. MEDICINE MRI PET CT. MAMMOGRAPHY . MAMMOGRAPHY PETM edicine NUCLEAR PET.

7 Full-Service, All Digital Imaging Network MAMMOGRAPHY CT. CT. west covina ONTARIO POMONA. DIAGNOSTIC RADIOLOGY CPT GUIDE 2018. MRI (MAGNETIC RESONANCE IMAGING) NUCLEAR MEDICINE . HEAD/ NECK w/o w/ w/ & w/o 3D BONE/ JOINT Scan Material Brain (incl. Brainstem) 70551 70552 70553 Bone and/or Joint Scan; Limited 78300 A9503. MR Angio Brain/ Head 70544 76377 Bone and/or Joint Scan, Whole Body 78306 A9503. MR Angio Neck 70547 70548 70549 76377 Bone and/or Joint Scan; 3 Phase Study 78315 A9503. Orbit, Face and/or Neck 70540 70542 70543 KIDNEY/ RENAL Scan Material Temporomandibular Joint(s) 70336 Renal w/o Pharma Intervention 78707 A9562. MR Venography 70545 70546 76377 Renal w/ Pharma Intervention (Diuretic/ Lasix) 78708 A9562. CHEST w/o w/ w/ & w/o 3D WHOLE BODY Scan Material Chest 71550 71551 71552 Gallium Scan, Whole Body, 2 or More Days 78804 A9556. Breast Bilateral 77059 Indium Scan, Whole Body, WBC 78806 A9570. MR Angio Chest (Excl.)

8 Myocardium) 71555 76377 Octreotide Scan 78804 A9572. Brachial Plexus 73218 73219 73220 HEPATOBILIARY TRACT/GALLBLADDER Scan Material SPINE/ PELVIS w/o w/ w/ & w/o 3D Hepatobiliary Scan (HIDA Scan) w/o Pharma 78226 A9537. Cervical Spine 72141 72142 72156 Hepatobiliary Scan (HIDA Scan) w/ Pharma 78227 A9537. Lumbar Spine 72148 72149 72158 CARDIOVASCULAR Scan Material Thoracic Spine 72146 72147 72157 Cardiac Stress Test (4 CPT codes required) 78452 multi study 93015 A9500 x 2. Pelvis/SI Joint/ Sacrum/ Coccyx 72195 72196 72197 Cardiac Blood Pool Imaging, Gated Equil, 78472 A9560. Cardiac Blood Pool Imaging, Gated Equil, Single Study Rest, w/. MR Angio Pelvis 72198 76377 78496. Rt Vent Eject (2nd MUGA Code). EXTREMITIES w/o w/ w/ & w/o 3D THYROID & PARATHYROID Scan Material Upper Extremity, Other Than Joint 73218 73219 73220 Thyroid Uptake, Scan w/ I-123 Capsule, Multiple 78014 A9516. Upper Extremity, Any Joint 73221 73222 73223 Thyroid Scan Only 78013 A9512.

9 Lower Extremity, Other Than Joint 73718 73719 73720 Parathyroid Imaging 78070 A9500. C. Lower Extremity, Any Joint 73721 73722 73723 LIVER & SPLEEN Scan Material MR Angio Upper Extremity 73225 76377 Liver-Spleen 78215 A9541. M. MR Angio Lower Extremity 73725 76377 PET (POSITRON EMISSION TOMOGRAPHY). 73725 x 2 Scan Material Y MR Angio Run-Off (Abdomen to Lower Extr) 76377 x 3. 74185 PET/CT Skull Base to Mid Thigh 78815 A9552. CM ABDOMEN w/o w/ w/ & w/o 3D PET/CT Whole Body (Skull Base to Extremities) 78816 A9552. Abdomen 74181 74182 74183 CT ARTHROGRAPHY (W/ CONTRAST ONLY). MY MR Angio Abdomen 74185 76377 Fluoro Needle Scan S8037 or Wrist (Requires all 3 codes) 77002 25246 73201. MRCP (Abdomen, Liver, Pancreas). CY. 74181 Elbow (Requires all 3 codes) 77002 24220 73201. CT (COMPUTED TOMOGRAPHY) Shoulder (Requires all 3 codes) 77002 23350 73201. CMY. HEAD/NECK w/o w/ w/ & w/o 3D Hip (Requires all 3 codes) 77002 27093 73701.

10 Angiography Head 70496 76377 Knee (Requires all 3 codes) 77002 27370 73701. K. Angiography Neck 70498 76377 Ankle (Requires all 3 codes) 77002 27648 73701. Head/Brain 70450 70460 70470 MRI ARTHROGRAPHY (W/ CONTRAST ONLY). Maxillofacial Area/Sinus/ TMJ/ Mandible 70486 70487 70488 Fluoro Needle Scan Orbit/Sella/P. Fossa/ Mastoid/ Temporal/ Ear 70480 70481 70482 Wrist (Requires all 3 codes) 77002 25246 73222. Soft tissue neck 70490 70491 70492 Elbow (Requires all 3 codes) 77002 24220 73222. CHEST w/o w/ w/ & w/o 3D Shoulder (Requires all 3 codes) 77002 23350 73222. Thorax/Chest 71250 71260 71270 Hip (Requires all 3 codes) 77002 27093 73722. Angiography Chest (Non Coronary/ Heart) 71275 76377 Knee (Requires all 3 codes) 77002 27370 73722. ABDOMEN w/o w/ w/ & w/o 3D Ankle (Requires all 3 codes) 77002 27648 73722. Abdomen 74150 74160 74170. Angiography Abdomen 74175 76377. ABDOMEN & PELVIS (BUNDLED) w/o w/ w/ & w/o 3D.