• RADIOLOGY

    2 views, front and back

    2 views, front and back

    3 views

    3 views

    A diagnostic procedure that allows a provider to see the organs and other structures in the abdomen

    A diagnostic procedure that allows a provider to see the organs and other structures in the abdomen

    A procedure most commonly ordered to detect areas of abnormal bone growth due to fractures, tumors, infection, or other bone issues

    Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus

    Abdominal ultrasound of pregnant uterus (less than 14 weeks) single or first fetus

    BREAST BIOPSY

    Complete bilateral study of the extremities

    Complete ultrasound of the pelvis

    Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections

    CT 3-D IND/WK STATION

    CT 3-D RECON AT CT

    CT CERVICAL SPINE W/CONTRAST

    CT CERVICAL SPINE W/OUT CONTRAST

    CT CERVICAL SPINE W/WO

    CT DORSAL SPINE

    CT DORSAL SPINE W/CON

    CT DORSAL SPINE W/WO CONTRAST

    CT DORSAL SPN W/O CONTRAS

    CT HEAD W & W/O CONTRAST

    CT HEAD WITH CONTRAST

    CT LIMITED/LOCALIZED STUD

    CT LOWER EXT W/CONT-RIGHT

    CT LOWER EXT W/CONTR-LEFT

    CT LOWER EXT W/O CONTRAST LEFT

    CT LOWER EXT W/WO LEFT

    CT LOWER EXT W/WO RIGHT

    CT LUMBAR SPINE W/CONTRAST

    CT LUMBAR SPINE W/WO

    CT MACILLO FACIAL AREA WITH

    CT MAXILLO FACIAL AREA W/WO

    CT NEEDLE BIOPSY/JT INJECT

    CT of abdomen and pelvis without dye

    CT of abdomen with and without dye

    CT of abdomen with dye

    CT of abdomen without dye

    CT of pelvis without dye

    CT ORBITS W/O

    CT ORBITS W/WO

    CT ORBITS WITH

    CT PELVIS W & W/O CON

    CT scan head or brain without dye

    CT scan of abdomen and pelvis with contrast

    CT scan of leg without dye

    CT scan of lower spine without dye

    CT scan of neck with dye

    CT Scan of the face and jaw without dye

    CT scan of the thorax with dye

    CT scan of the thorax without dye

    CT scan, pelvis, with contrast

    CT SOFT TISSUE NECK W/WO

    CT SOFT TISSUE NECK WO

    CT THORACIC SPINE W/O

    CT THORACIC SPINE W/WO

    CT THORACIC SPINE WITH

    CT THORAX W/OUT CONTRAST

    CT THORAX W/WO CONTRAST

    CT UNLISTED DIAG CT PROCEDUR

    CT UPPER EXT W/CONT-LEFT

    CT UPPER EXT W/CONT-RIGHT

    CT UPPER EXT W/O-LEFT

    CT UPPER EXT W/O-RIGHT

    CT UPPER EXT W/WO LEFT

    CT UPPER EXT W&W/O-RIGHT

    CTA ABDOMEN AND PELVIS

    CTA ABDOMEN W/WO

    CTA AORTA W/RUNOFF W/WO

    CTA HEAD W/WO

    CTA LOWER EXTREMITY W/WO

    CTA NECK W/WO

    CTA PELVIS W/WO

    CTA UPPER EXTREMITY W/WO

    Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral

    Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral

    Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral

    Diagnostic Radiology (Diagnostic Imaging) Procedures of the Chest

    Diagnostic ultrasound of an extremity excluding the bone, joints or vessels

    Draining or injecting medication into a large joint/bursa without ultrasound

    Draining or injecting medication into a major joint/bursa without ultrasound

    Evaluation through measurement of fetal nuchal translucency

    Fetal biophysical profile with non-stress test

    Fetal biophysical profile without non-stress test

    Fine Needle Aspiration Biopsy without imaging

    Flouroscopy, or x-ray "movie" that takes less than an hour

    Image of the heart to assess perfusion

    Image of the heart to assess perfusion

    Image of the heart to assess perfusion

    INJECTION FOR MYELOGRAPHY

    Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries

    Limited ultrasound of the breast

    Mammography of both breasts-2 or more views

    MM 3D MAMMO BIL DIAGNOSTIC

    MM 3D MAMMO BIL SCREENING

    MM 3D MAMMO UNILATERAL LEFT

    MM 3D MAMMO UNILATERAL RIGHT

    MM BREAST BX PERCUT NO IMAGI

    MM DIGITAL SPOT MAG BILATERAL

    MM MAMMOGRAM/BIOPSY

    MM MAMMOGRAM/TISSUE

    MRA ABDOMEN

    MRA BRAIN W/WO CONTRAST

    MRA CHEST

    MRA HEAD W/OUT

    MRA LOWER EXT W/O CONTRAST

    MRA LOWER EXT W/O & W/CONTRAST

    MRA NECK W/O

    MRA NECK W/WO CONTRAST

    MRA PITUITARY WITH CONTRA

    MRI ABD W/ CONTRAST

    MRI BONE MARROW BLOOD

    MRI BRAIN W/CONTRAST

    MRI CERVICAL SPINE W/CON

    MRI CHST/HILAR/MEDIASTINA

    MRI FACIAL ORBITS FACE W/O

    MRI FACIAL ORBITS FACE W/WO

    MRI FACIAL ORBITS FACE WITH

    MRI LOWER EXT NON JNT W LT

    MRI LOWER EXT NON JNT W RT

    MRI LOWER EXT NON JNT W/WO LT

    MRI LOWER EXT NON JNT W/WO RT

    MRI LUMBAR SPINE WITH

    MRI MYOCARDIUM W/O CONTRA

    MRI NECK W/0

    MRI NECK WITH

    MRI of abdomen without and with dye

    MRI of abdomen without dye

    MRI of brain stem without dye

    MRI of chest and spine with and without dye

    MRI of chest and spine without dye

    MRI of leg without dye

    MRI of lower back with and without dye

    MRI of lower extremity joint (knee/ankle) with and without dye

    MRI of lower extremity joint (knee/ankle) with dye

    MRI of lower extremity joint (knee/ankle) without dye

    MRI of neck/spine with and without dye

    MRI of pelvis before and after dye

    MRI of pelvis without dye

    MRI of the neck or spine without dye

    MRI of upper extremity without dye

    MRI ORBITS W/O

    MRI ORBITS WITH

    MRI ORBITS, FACE, AND/OR NECK W/WO

    MRI PELVIC W/CONTRAST

    MRI scan of brain before and after contrast

    MRI scan of lower spinal canal

    MRI TMJ

    MRI UPPER EXT JOINT W/CONTRAST

    MRI UPPER EXT NON-JT WITHOUT

    MRI UPPER EXT W/WO LEFT JNT

    MRI UPPER EXT W/WO RIGHT JNT

    MRI UPPER EXTREMITY-LEFT WITH

    MRI UPPER EXTREMITY-RIGHT WITH

    MRI UPPER RXT NON-JT W/WO

    MRI UPR EXT/NON JNT-LEFT W/O

    NM GASTRIC EMPTYING

    NM HIDA W/O EJECTION FRACTION

    NM HIDA WITH EJECTION FRACTION

    NM I 123 CAPSULE 200 PER UCI

    NM I 123 THYROID MULTIDETECT

    NM INTESTINE IMAGING

    NM LIVER/SPLEEN (NO SPECT)

    NM LTD AREA BONE SCAN

    NM MUGA

    NM MYOCARDIAL SPECT SINGLE S

    NM PARATHYROID

    NM PULMONARY PERFUSION

    NM PULMONARY VENTILATION SCAN

    NM PULMONARY VENTILATION/PERFUSION

    NM RENAL SCAN

    NM RENAL SCAN W/CAPTOPRIL

    NM TC04 TECHNETATE

    NM TC99M CARDIOLITE

    NM TC99M CHOLETEC (MEBROFENIN)

    NM TC99M DTPA

    NM TC99M HEPATOLITE

    NM TC99M MAA 10 MCI

    NM TC99M SULFUR COLLOID

    NM TESTICULAR SCAN

    NM THREE PHASE BONE SCAN

    NM THYROID IMAGING ONLY

    One sided or limited bilateral study

    One sided or limited bilateral study

    PERITONOCENTESIS

    Radiologic examination of both knees

    Radiologic examination of one side of the chest/ribs

    Radiologic examination of the ankle with 2 views

    Radiologic examination of the ankle with 3 views

    Radiologic examination of the collar bone

    Radiologic examination of the finger(s)

    Radiologic examination of the foot with 3 or more views

    Radiologic examination of the forearm

    Radiologic examination of the heel

    Radiologic examination of the knee with 1 or 2 views

    Radiologic examination of the knee with 3 views

    Radiologic examination of the knee with 4 or more views

    Radiologic examination of the lower leg

    Radiologic examination of the middle spine, 2 views

    Radiologic examination of the neck/spine, 2-3 views

    Radiologic examination of the neck/spine, 4-5 views

    Radiologic examination of the pelvis

    Radiologic examination of the shoulder

    Radiologic examination of the toe(s)

    Radiologic examination, elbow; 2 views

    Radiologic examination, elbow; 3 or more views

    Scan to measure bone mineral density (BMD) at the spine and hip

    Scan to measure bone mineral density (BMD) at the spine and hip

    Scan using a radioactive medication (radiopharmaceutical) to take pictures or images of the thyroid gland.

    Serial radiologic examination of the abdomen

    Single view

    Study of vessels on both sides of the head and neck

    THORACENTESIS FOR ASPIRATION

    THORACENTESIS W/ TUBE INSERT

    Transvaginal ultrasound of uterus

    Ultrasound of abdomen with all areas scanned

    Ultrasound of back wall of the abdomen with all areas viewed

    Ultrasound of back wall of the abdomen with limited areas viewed

    Ultrasound of fetus with limited views

    Ultrasound of head and neck

    Ultrasound of head and neck

    Ultrasound of single fetus

    Ultrasound of the pelvis through vagina

    Ultrasound of the scrotum

    Up to 3 views

    US 1ST TRIM FETAL NUC MEA EACH ADDITION

    US ADDITIONAL CYST ASPIRATION

    US AMNIOCENTESIS GUIDANC

    US AORTIC LOW EXT-LEFT

    US AORTIC LOW EXT-RIGHT

    US ARTERIAL LOWER EXT/BIL

    US ARTERIAL-SCROTAL

    US ARTERIAL-SCROTAL-LIMITED

    US AV GRAFT IMAGE

    US BIL PHYSOLOGIC SEG AR

    US BILAT ARTERIAL LOW EX

    US CAROTID UNI LEFT

    US CAROTID UNI RIGHT

    US COMP PSEUDOANURYS GUI

    US CYST ASPIRATION

    US CYST GUIDANCE NEEDLE

    US DOPPLER VELOCIMETRY FETAL UMBILICAL

    US DUP AORTA/IVC/COMPLET

    US DUPLEX ART ABD LTD

    US DUPLX AORTA/IVC/LIMIT

    US DUPLX SCAN PENILE VES

    US ECHOENCEPHALOGRAPHY

    US FETAL < 14 WKS EACH ADDITIONAL

    US FETAL >14 WKS EACH ADDITIONAL FETUS

    US FETAL GROWTH PARA IURG FOLLOW-UP

    US GUIDANCE CYS/ANY LOCATION

    US GUIDANCE INTRAOPERATIVE

    US GUIDANCE INTRAOPERATIVE

    US GUIDANCE-NEEDLE BIOPS

    US GUIDE THORA/PARACENTIS

    US GUIDE VASCULAR ACCESS

    US IMPOT PENILE STUDY PLETHYSMOGRAPHY

    US PHYS EXT VENOUS/CMPLT-BIL

    US PHYS LOWER EXT/REST-BIL

    US PHYS UP/LOW ART/MULTI-BIL

    US PHYSL SEG EXERCISE-BIL

    US TRANSPLANT KIDNEY

    US UPPER ARTERIAL-BIL

    US UPPER ARTERIAL-LEFT

    US UPPER ARTERIAL-RIGHT

    US VASCULAR-AORTA-IVC-ILIAC-COMPLETE

    X-ray of lower and sacral spine, minimum of 4 views

    X-ray of the hand with 3 or more views

    X-ray of the lower spine 2-3 views

    XR A C JOINTS

    XR ABD/KUB

    XR ABDOMEN FLATUPRIGHT

    XR ARTHROGRAM SHOULDER

    XR ASPIR FINE NDLE W IMAGE G

    XR BARIUM ENEMA - BE

    XR BARIUM ENEMA AIR CON

    XR BARIUM SWALLOW

    XR BARIUM SWALLOW/MODIFIED

    XR BONE AGE

    XR BONE SURVEY-COMPLETE

    XR CHEST AND OBLIQUES

    XR CHEST FLUOROSCOPY

    XR COCCYX OR SACRUM

    XR CYSTOGRAM

    XR CYSTOURETHROGRAM

    XR EXAM ENTIRE SPINE 2/3 VIEWS

    XR EXTRA VIEWS

    XR FACIAL BONES 4 VIEWS

    XR FEMUR AP/LAT LT

    XR FEMUR AP/LAT RT

    XR FLURO GUIDANCE NEEDLE PLACEMENT

    XR FLUROSCOPY OF LARYNX

    XR FLUROSCOPY PORTACATH INSERT

    XR GASTRIC TUBE INJECTION

    XR GI / AC

    XR GI BARIUM SWALLOW

    XR GI SINGLE CONTRAST

    XR GI W/SB SINGLE CONTRAST

    XR GI/AC W/SB

    XR HIP AP/LATERAL LT

    XR HIP AP/LATERAL RT

    XR HIPS BIL WITH AP/PELVIS

    XR HUMERUS AP/LATERAL LT

    XR HUMERUS AP/LATERAL RT

    XR HYSTERIOSALPINGOGRAM

    XR INJECTION PROCEDURE FOR SIALOGRAPHY

    XR INJECTION SHOULDER ARTHROGRAM

    XR INJECTION SINUS TRACT OR DRAIN

    XR IVP

    XR KIDIGRAM

    XR LOWER EXTRMITY TOTAL LT

    XR LOWER EXTRMITY TOTAL RT

    XR MANDIBLE 4 VIEWS COMPLETE

    XR MANDIBLE/LTD LESS 4 VIEWS

    XR MYELO CERVICAL

    XR MYELO LUMBAR

    XR MYELO THORACIC

    XR NASAL BONES 3 VIEWS

    XR NECK SOFT TISSUE

    XR OPER CHOLANGI 2ND SET FILMS

    XR OPER CHOLANGIOGRAM

    XR ORBITS 4 VIEWS

    XR PELVIS/BOTH OBLIQUES 3 VW

    XR RETROGRADE IVP

    XR RIBS BILAT W PA CHEST 4 VIEWS

    XR RIBS BILAT W/O CHEST 3 VIEWS

    XR RIBS UNILAT LEFT W/O PA CHEST 2 VIEW

    XR RIBS UNILAT RT W/O PA CHEST 2 VIEW

    XR SACROILLIAC JOINTS 3 VIEW

    XR SCAPULA LT

    XR SCAPULA RT

    XR SCOLIOSIS SURVEY

    XR SIALOGRAPHY

    XR SINUSES 4 VIEWS

    XR SKULL 4 VIEWS

    XR SKULL/LTD 2 VIEWS

    XR SMALL BOWEL

    XR SPINE SINGLE VIEW

    XR SPINE THORACIC 4 VIEWS

    XR SPINE/CER SP WITH FLEX & EXT

    XR SPINE/LUMBAR W/FLEX EXT

    XR SPINE/LUMBAR FLEX EX ONLY

    XR STERNO/CLAV JTS 3 VIEWS

    XR STERNUM-AP/LAT/OBLIQUES

    XR T-M JOINTS TOMO/BILATERAL

    XR TOTAL EXTRMITY UPPER LT

    XR TOTAL EXTRMITY UPPER RT

    XR VENOGRAM LT

    XR VENOGRAM RT

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