X-RAY PROTOCOLS - Imaging Healthcare

1 71045CR chest 1V1 chest 1 view, chest PA/AP, Pos PPD71046CR chest 2V2 CXR, chest PA and LAT 71047CR chest 2V w/ Apical Lordotic3 CXR w/apical lordotic, chest 3V71022CR chest 2V w/ Obl4 Asbestos Study, CXR w/obliques71120CR Sternum Min 2V2 Sternum, Breast bone71101CR Ribs Min 2V (Lt or Rt) w/ chest 1V3-5L or R Ribs 71111CR Ribs Bilat Min 2V w/ chest 1V3-7 Ribs Bilat, Bilateral Ribs, Ribs L and R70360CR Neck for Soft Tissue1-2 Soft Tissue Neck, Neck, Neck Foreign Body72040CR Cervical Spine 2V/3V2-3C-spine, CS spine72050CR Cervical Spine 4V/5V4-5C-spine w/ obliques, C-spine complete72052CR Cervical Spine w/ Flex & Ext Min 5V5-7C-spine flex/ext, C-spine with bending72052 DSCR Cervical Spine 7V Davis7-8C-spine Complete w/ flex/ext, C-spine w/ obliques flex/ext,72070CR Thoracic Spine 2V/3V2-3T-spine, upper back, Thoracic spine72074CR Thoracic Spine Min 4V4-5T-spine w/ obliques, T-spine w/ flex/ext72100CR Lumbar Spine 2V/3V2-3L-S spine.

2 Lumbar spine, lower back72110CR Lumbar Spine Min 4V4-5L-spine complete, L spine 5 view, L-spine w/obliques72114CR Lumbar Spine Min 5V w/ Bending5-7L-spine complete with bending, L spine w/ flex/ext, L-spine complete w/ flex/ext72069CR Scoliosis2-4 Scoliosis screening , Scoli, Thoraco-lumbar for scoliosis72220CR Sacrum Coccyx Min 2V2-3 Sacrum/Coccyx, sacral spine, tailbone72170CR Pelvis 1V/2V1-2AP Pelvis, Pelvis, Weight bearing Pelvis73510CR Hip Lt or Rt (includes Pelvis & Hip)2-3Lt or Rt hip, Hip and Pelvis73520CR Hip Bilat Min 2V 2-5 Bilateral Hips, Bilat Hips and Pelvis72202CR Sacroiliac Joints Min 3V3SI Joints, Sacroiliac Jts, 73030CR Shoulder Min 2V 2-6Lt, Rt, or Bilat Shoulder73010CR Scapula 2-4Lt, Rt, or Bialt Scapula, Shoulder Blade73000CR Clavicle 2-4Lt, Rt, or Bilat Clavicle, Collar bone73050CR Acromioclavicular Joint2-4AC joints, AC joints w and w/o weight74018CR Abdomen 1V1 KUB, 1VW ABD 74019CR Abdomen Complete 2V2 ABD Upright and Supine74022CR Acute Abdomen 2V w/ chest 1V3 AAS.

3 Acute Abdomen SeriesCHEST & BONY THORAXSPINEPELVIS/HIPSHOULDERABDOMENCPT CODE# VIEWSEXAM DESCRIPTIONCOMMON WRITTEN ORDER EXAMPLESX-RAY PROTOCOLS If number of views is listed on the order, default to the order If number of views is not listed on the order, follow Imaging Healthcare Specialists PROTOCOLS NOTE: Only the most common exams are listed below IHS PROTOCOLS X-rays only: Walk-in/No Appt X-RAY must be scheduled when ordered with other examsImaging Healthcare Specialists T 866 558 4320 F 866 558 4329 V (Continued on next page)73060CR Humerus 2-4Lt, Rt, or Bilat Humerus, Upper Arm73070CR Elbow 2V 2-4Lt, Rt, or Bilat Elbow, Elbow limited73080CR Elbow Min 3V 3-8Lt, Rt, or Bilat Elbow, Elbow complete73090CR Forearm 2V2-4Lt, Rt, or Bilat Forearm, Lower Arm73100CR Wrist 2V2-4Lt, Rt, or Bilat Wrist, Wrist limited73110CR Wrist Min 3V3-8Lt, Rt, or Bilat Wrist, Wrist complete73120CR Hand 1V/2V (includes fingers)2-4Lt, Rt, or Bilat Hand, Hand limited73130CR Hand Min 3V (includes fingers)

4 3-7Lt, Rt, or Bilat Hand, Hand Complete73140CR Finger Min 2V2-4Lt, Rt, or Bilat Finger or Thumb77072CR Bone Age Study1 Bone Age, Hand 1V for bone age73550CR Femur 2V2-8Lt, Rt, or Bilat Femur, Thigh, Upper leg73560CR Knee 1V/2V2-4Lt, Rt, or Bilat Knee 2 view, AP/Lat, limited73562CR Knee 3V3-6Lt, Rt, or Bilat Knee 3 view, complete, AP/Lat/OBL73564CR Knee Min 4V4-9Lt, Rt, or Bilat Knee 4 view, as ordered 4V73590CR Tibia/Fibula 2V2-6Lt, Rt, or Bilat Tib/Fib, Lower leg, shin73600CR Ankle 1V/2V1-4Lt, Rt, or Bilat Ankle 2V, AP/Lat, limited73610CR Ankle 3V3-6Lt, Rt, or Bilat Ankle 3V, complete, APOL73620CR Foot 2V (includes toes)2-4Lt, Rt, or Bilat Foot 2V, AP/LAT, limited73630CR Foot Min 3V (includes toes)

5 3-6Lt, Rt, or Bilat Foot 3V, complete, APOL73650CR Heel Min 2V2-6Lt, Rt, or Bilat Heel, Calcaneus, Os Calcis73660CR Toe Min 2V2-6Lt, Rt, Toes, or individual toe70250CR Skull Less than 4V1-3 Skull AP/LAT, Skull 2V, Skull limited70260CR Skull Min 4V4-5 Skull complete, Skull Min 3V70210CR Sinus Less than 3V1-2 Sinus Waters, Sinus 2V, Sinus Limited70220CR Sinus Min 3V3-5 Sinus, Sinus Complete, Sinus 3V70140CR Facial Bone Less than 3V1-2 Facial Bone limited, Facial bone PA Lat70150CR Facial Bone Min 3V3-4 Facial Bones, Zygoma, Maxillae 70200CR Orbit Min 4V4-6Lt, Rt, or Bilat Orbits, Facial Orbits70030CR Orbit Detection of Foreign Body1-2MR Metal screening , Orbit Metal screening70100CR Mandible Partial Lt, Rt3-4Lt, Rt Mandible, Jaw70110CR Mandible Min 4V4-8 Mandible, Jaw70330CR TMJ Bilat4-6 TMJ, Temporomandibular Joint 70160CR Nasal Bone Min 3V3 Nose, Nasal bone70130CR Mastoid3-5 MastoidsUPPER EXTREMITYLOWER EXTREMITYSKULL/HEADCPT CODE# VIEWSEXAM DESCRIPTIONCOMMON WRITTEN ORDER EXAMPLES77075 Bone Survey Adult19X-ray Bone Survey, Bone study, METS study77076 Bone Survey Infant9-23X-ray Bone Survey, X-RAY Bone studyBONE SURVEY73592CR Lower Extremity Infant3-8 Pediatric leg, lower limb, Hip-foot76010CR Nose to Rectum for Foreign Body1-2 Pediatric foreign body.

6 Swallow FB check73092CR Upper Extremity Infant2-6 Pediatric arm, Shoulder-hand, upper limbPEDIATRIC SPECIALSI maging Healthcare Specialists T 858 658 6500 F 866 558 4329 V