Read Anthem Central Region_AIM 2010 CPT Listingfinal (2).xls text version

Radiology Management Precertification CPT Code List

Effective 1/1/2010

0340 0341 0349 0350 0351 0352 0359 0404 0610 0611 0612 0614 0615 0616 0618 0619 Computerized Tomography (CT) Abdomen CPT 74150 74160 74170 71250 71260 71270 73200 73201 73202 73700 73701 73702 70450 70460 70470 70480 70481 70482 70486 70487 70488 70490 70491 70492 72192 72193 72194 72125 72126 72127 72128 72129 72130 72131 72132 72133 Nuclear Medicine - Genera Nuclear Medicine - Diagnostic Nuclear Medicine - Other CT Scan - General CT Scan - Head Scan CT Scan - Body Scan CT Scan - Other Other Imaging - PET Magnetic Resonance Technology - General Classification Magnetic Resonance Technology MRI - Brain Magnetic Resonance Technology MRI - Spinal Cord Magnetic Resonance Technology MRI - Other Magnetic Resonance Technology MRA - Head and Neck Magnetic Resonance Technology MRA - Lower Extremities Magnetic Resonance Technology MRA - Other Magnetic Resonance Imaging - Other Description CT abdomen; w/o contrast CT abdomen; with contrast CT abdomen; w/o contrast followed by contrast CT thorax; w/o contrast CT thorax; with contrast CT thorax; w/o contrast followed by contrast CT upper extremity; w/o contrast CT upper extremity; with contrast CT upper extremity; w/o contrast followed by contrast CT lower extremity; w/o contrast CT lower extremity; with contrast CT lower extremity; w/o contrast followed by contrast CT head or brain; w/o contrast CT head or brain; with contrast CT head or brain; w/o contrast followed by contrast CT orbit, sella or posterior fossa; w/o contrast CT orbit, sella or posterior fossa; with contrast CT orbit, sella or posterior fossa; w/o contrast followed by contrast CT maxillofacial area; w/o contrast CT maxillofacial area; with contrast CT maxillofacial area; w/o contrast followed by contrast CT soft tissue neck; w/o contrast CT soft tissue neck; with contrast CT soft tissue neck; w/o contrast followed by contrast CT pelvis; w/o contrast CT pelvis; with contrast CT pelvis w/o contrast followed by contrast CT cervical spine; w/o contrast CT cervical spine; with contrast CT cervical spine; w/o contrast followed by contrast CT thoracic spine; w/o contrast CT thoracic spine; with contrast CT thoracic spine; w/o contrast followed by contrast CT lumbar spine; w/o contrast CT lumbar spine; with contrast CT lumbar spine; w/o contrast followed by contrast

Chest

Upper Extremity Lower Extremity Head

Orbit

Sinus

Neck

Pelvis

Cervical Spine Thoracic Spine Lumbar Spine Computerized Tomography Angiography (CTA) Abdomen Abdominal Arteries Chest Upper Extremity Lower Extremity Head Neck Pelvis

CPT 74175 75635 71275 73206 73706 70496 70498 72191

Description CTA abdomen CTA abdominal aorta & bilateral iliofemoral lower extremity runoff CTA chest CTA upper extremity CTA lower extremity CTA head CTA neck CTA pelvis

Magnetic Resonance Imaging (MRI) CPT 74181 Abdomen 74182 74183 Bone Marrow Breast Chest 77084 77058 77059 71550 71551 71552 75557 75559 75561 75563 Upper Extremity Non-joint Upper Extremity Any Joint Lower Extremity 73218 73219 73220 73221 73222 73223 73718 73719 73720 73721 73722 73723 70336 70540 70542 70543 70551 70552 70553 72195 72196 72197 72141 72142 72156 72146 72147 72157 72148 72149 72158 S8042

Description MRI abdomen; w/o contrast MRI abdomen; with contrast MRI abdomen; w/o contrast followed by contrast MRI bone marrow blood supply MRI breast; unilateral MRI breast; bilateral MRI chest; w/o contrast MRI chest; with contrast MRI chest; w/o contrast followed by contrast MRI Cardiac for morphology and function without contrast material MRI Cardiac for morphology and function without contrast material; with stress imaging MRI Cardiac for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; MRI Cardiac for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging MRI upper extremity, other than joint w/o contrast MRI upper extremity, other than joint with contrast MRI upper extremity, other than joint w/o contrast followed by contrast MRI upper extremity, any joint w/o contrast MRI upper extremity, any joint with contrast MRI upper extremity, any joint w/o contrast followed by contrast MRI lower extremity, other than joint w/o contrast MRI lower extremity, other than joint w contrast MRI lower extremity, other than joint w/o contrast followed by contrast MRI lower extremity, any joint w/o contrast MRI lower extremity, any joint w contrast MRI lower extremity, any joint w/o contrast followed by contrast MRI temporomandibular joint(s) MRI orbit, face and neck; w/o contrast MRI orbit, face and neck; with contrast MRI orbit, face and neck; w/o contrast followed by contrast MRI brain; w/o contrast MRI brain; with contrast MRI brain; w/o contrast followed by contrast MRI pelvis; w/o contrast MRI pelvis; with contrast MRI pelvis; w/o contrast followed by contrast MRI cervical spine; w/o contrast MRI cervical spine; with contrast MRI cervical spine; w/o contrast followed by contrast MRI thoracic spine; w/o contrast MRI thoracic spine; with contrast MRI thoracic spine; w/o contrast followed by contrast MRI lumbar spine; w/o contrast MRI lumbar spine; with contrast MRI lumbar spine; w/o contrast followed by contrast MRI

Cardiac

TMJ Orbit

Brain

Pelvis

Cervical Spine Thoracic Spine Lumbar Spine MRI

Magnetic Resonance Angiography (MRA) Abdomen Chest Upper Extremity Lower Extremity Head

Neck

Pelvis Spinal Canal

CPT 74185 71555 73225 73725 70544 70545 70546 70547 70548 70549 72198 72159

Description MRA abdomen; with or w/o contrast MRA chest; with or w/o contrast MRA upper extremity; with or w/o contrast MRA lower extremity; with or w/o contrast MRA head; w/o contrast MRA head; with contrast MRA head; w/o contrast followed by contrast MRA neck; w/o contrast MRA neck; with contrast MRA neck; w/o contrast followed by contrast MRA pelvis; with or w/o contrast MRA spinal canal and contents with or w/o contrast

Magnetic Resonance Spectroscopy (MRS) CPT 76390

Description MR Spectroscopy

QCT Bone Densitometry

CPT 77078 77079 CPT 78451

Description CT bone mineral density study; axial skeleton CT bone mineral density study; appendicular skeleton Description Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic) Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress reinjection Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic) Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) Planar, infarct avid; qualitative or quantitative Planar, infarct avid; with ejection fraction by first pass technique SPECT, infarct avid; with or w/o quantification Gated equilibrium; planar, single study, wall motion plus ejection fraction Gated equilibrium; planar, multiple studies, wall motion study plus ejection fraction First pass tech; single study, wall motion study plus ejection fraction First pass tech; multiple studies, wall motion study plus ejection fraction Gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction

Nuclear Cardiology Myocardial Perfusion Imaging

78452

78453

78454

Infarct Imaging Cardiac Blood Pool Imaging

78466 78468 78469 78472 78473 78481 78483 78494

Positron Emission Tomography (PET) CPT 78608 Brain 78609 Imaging Myocardial Imaging 78459 78491 78492

Description PET brain, metabolic evaluation PET brain, perfusion evaluation PET myocardial, metabolic evaluation PET myocardial, perfusion, single study PET myocardial, perfusion, multiple studies

PET and PET/CT Fusion

CPT 78811 78812 78813 78814 78815 78816 CPT 74263

Description PET imaging, limited PET imaging, skull to mid-thigh PET imaging, whole body PET imaging with concurrent CT, limited PET imaging with concurrent CT, skull to mid-thigh PET imaging with concurrent CT, whole body Description Computed tomographic (CT) colonography, screening, including image postprocessing Description Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed Description Functional MRI brain not requiring physician administration Functional MRI brain requiring physician administration Description Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium Description Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed) Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of LV cardiac function, RV structure and function and evaluation of venous structures, if performed)

Screening CT Colonoscopy

Diagnostic CT Colonography

CPT 74261 74262

Functional MRI Brain CPT 70554 70555 CT Heart for Calcium Scoring CPT 75571 CT Heart for Structure & Morph

CPT 75572

75573

CTA Heart Incl Structure & Morph

CPT 75574

Description Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures if performed)

Add-on Procedures CPT CT or MRI Grouping 76376* 76377* Cardiac MRI Grouping Cardiac Blood Pool Grouping 75565* 78496*

Description 3 D Reconstruction of CT or MRI images

Cardiac magnetic resonance imaging for velocity flow mapping (List separately in addition to code for primary procedure) Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (Add-on to 78472 only)

Radiology Management Pre-Notification CPT Code List

Echocardiogram Stress Echo (SE) CPT Description 93350 Transthoracic Stress Echo, complete 93351 Transthoracic Stress Echo, complete w cont EKG 93303 Transthoracic Echo cardiac anomalies 93304 Transthoracic Echo cardiac anomalies, limited 93306 Transthoracic Echo complete w color & spectral 93307 Transthoracic Echo complete wo color & spectral 93308 Transthoracic Echo limited 93312 Transesophageal Echo 93313 Transesophageal Echo probe only 93314 Transesophageal Echo interpretation 93315 Transesophageal Echo congenital 93316 Transesophageal Echo congenital, probe only 93317 Transesophageal Echo congenital interpretation Echo Add-On Codes CPT 93320* 93321* 93325* 93352* Description Doppler Echo complete Doppler Echo limited Doppler Echo flow velocity Echo contrast agent (SE only)

Resting Trans Echo (TTE)

Transesophageal Echo (TEE)

* Denotes a CPT code that is on the add-on/secondary code included in the grouper, but not requiring review.

Information

Anthem Central Region_AIM 2010 CPT Listingfinal (2).xls

4 pages

Find more like this

Report File (DMCA)

Our content is added by our users. We aim to remove reported files within 1 working day. Please use this link to notify us:

Report this file as copyright or inappropriate

453445


You might also be interested in

BETA
Anthem Central Region_AIM 2010 CPT Listingfinal (2).xls
CR_AIM 2012 CPT Listing 1-1-2012_POSTED v2.xls