HEAD/ NECK w/o w/ w/ & w/o 3D Scan MaterialBrain (incl. Brainstem) 70551 70552 70553 78300 A9503MR Angio Brain/ Head 70544 76377 78306 A9503MR Angio Neck 70547 70548 70549 76377 78315 A9503Orbit, Face and/or Neck 70540 70542 70543 Scan MaterialTemporomandibular Joint(s) 70336 78707 A9562MR Venography 70545 70546 76377 Renal w/ Pharma Intervention (Diuretic/ Lasix) 78708 A9562CHEST w/o w/ w/ & w/o 3D WHOLE BODY Scan Scan MaterialChest 71550 71551 71552 Gallium Scan, Whole Body, 2 or More Days 78835 78804 A9556Breast Unilateral w/ CAD 77048 Indium Scan, Whole Body, WBC 78804 A9570Breast Bilateral w/ CAD 77049 Octreotide Scan 78804 A9572MR Angio Chest (Excl. Myocardium) 71555 76377 HEPATOBILIARY TRACT/GALLBLADDER Scan MaterialBrachial Plexus 73218 73219 73220 Hepatobiliary Scan (HIDA Scan) w/o Pharma 78226 A9537SPINE/ PELVIS w/o w/ w/ & w/o 3D Hepatobiliary Scan (HIDA Scan) w/ Pharma 78227 A9537Cervical Spine 72141 72142 72156 CARDIOVASCULAR Scan MaterialLumbar Spine 72148 72149 72158 93015 A9500 x 2Thoracic Spine 72146 72147 72157 Cardiac Blood Pool Imaging, Gated Equil, 78472 A9560Pelvis/SI Joint/ Sacrum/ Coccyx 72195 72196 72197 78496MR Angio Pelvis 72198 76377 THYROID & PARATHYROID Scan MaterialEXTREMITIES w/o w/ w/ & w/o 3D Thyroid Uptake, Scan w/ I-123 Capsule, 78014 A9516Upper Extremity, Other Than Joint 73218 73219 73220 Thyroid Scan Only 78013 A9512Upper Extremity, Any Joint 73221 73222 73223 Parathyroid Imaging 78070 A9500Lower Extremity, Other Than Joint 73718 73719 73720 LIVER & SPLEEN Scan MaterialLower Extremity, Any Joint 73721 73722 73723 Liver-Spleen 78215 A9541MR Angio Upper Extremity 73225 76377MR Angio Lower Extremity 73725 76377 Scan Material

PET/CT Skull Base to Mid Thigh 78815 A9552PET/CT Whole Body (Skull Base to 78816 A9552

ABDOMEN w/o w/ w/ & w/o 3DAbdomen 74181 74182 74183 Fluoro Needle ScanMR Angio Abdomen 74185 76377 Wrist (Requires all 3 codes) 77002 25246 73201

Elbow (Requires all 3 codes) 77002 24220 73201Shoulder (Requires all 3 codes) 77002 23350 73201

CT (COMPUTED TOMOGRAPHY) Hip (Requires all 3 codes) 77002 27093 73701HEAD/NECK w/o w/ w/ & w/o 3D Knee (Requires all 3 codes) 77002 27370 73701Angiography Head 70496 76377 Ankle (Requires all 3 codes) 77002 27648 73701Angiography Neck 70498 76377Head/Brain 70450 70460 70470 Fluoro Needle ScanMaxillofacial Area/Sinus/ TMJ/ Mandible 70486 70487 70488 Wrist (Requires all 3 codes) 77002 25246 73222Orbit/Sella/P. Fossa/ Mastoid/ Temporal/ Ear 70480 70481 70482 Elbow (Requires all 3 codes) 77002 24220 73222Soft tissue neck 70490 70491 70492 Shoulder (Requires all 3 codes) 77002 23350 73222CHEST w/o w/ w/ & w/o 3D Hip (Requires all 3 codes) 77002 27093 73722Thorax/Chest 71250 71260 71270 Knee (Requires all 3 codes) 77002 27369 73722Angiography Chest (Non Coronary/ Heart) 71275 76377 Ankle (Requires all 3 codes) 77002 27648 73722ABDOMEN w/o w/ w/ & w/o 3DAbdomen 74150 74160 74170Angiography Abdomen 74175 76377ABDOMEN & PELVIS (BUNDLED) w/o w/ w/ & w/o 3DAbdomen & Pelvis 74176 74177 74178Angiography Abdomen & Pelvis 74174 76377 IMPORTANT #1: FOR NUCLEAR, PET & ARTHROGRAPHY STUDIES, Urogram 74178 PLEASE AUTHORIZE ALL CODES LISTED FOR THAT STUDY.SPINE/ PELVIS w/o w/ w/ & w/o 3DCervical Spine 72125 72126 72127 IMPORTANT #2: FOR ALL MRI & CT ANGIOGRAPHY, CT JOINTS &Lumbar Spine 72131 72132 72133 SPINE, PLEASE AUTHORIZE 3D RECONSTRUCTION CODE LISTEDThoracic Spine 72128 72129 72130 FOR THAT STUDY.Pelvis 72192 72193 72194Angiography Pelvis 72191 76377 *** If the study is not listed on this guide, please call ourEXTREMITIES w/o w/ w/ & w/o 3D office for additional assistance.Lower Extremity 73700 73701 73702Upper Extremity 73200 73201 73202 Rev 01282021 © Copyright | Centrelake 2021Angiography Lower Extremity 73706 76377Angiography Upper Extremity 73206 76377CT Angio Run-Off (Abdomen to Lower Extr) 75635 76377Low Dose CA Screening 71271

MR Angio Run-Off (Abdomen to Lower Extr)

MRCP (Abdomen, Liver, Pancreas)S8037

or 74181

MRI ARTHROGRAPHY (W/ CONTRAST ONLY)

MRI (MAGNETIC RESONANCE IMAGING)

CT ARTHROGRAPHY (W/ CONTRAST ONLY)

Cardiac Stress Test (4 CPT codes required) 78452 multi

PET (POSITRON EMISSION TOMOGRAPHY)

Cardiac Blood Pool Imaging, Gated Equil, Single Study

73725 x 2 74185

76377 x 3

DIAGNOSTIC RADIOLOGY CPT GUIDE 2021

Bone and/or Joint Scan; LimitedBONE/ JOINTNUCLEAR MEDICINE

Renal w/o Pharma Intervention KIDNEY/ RENALBone and/or Joint Scan; 3 Phase StudyBone and/or Joint Scan, Whole Body

ULTRASOUNDBONE & JOINTS HEAD/NECKBone Age Studies 77072 Soft tissues of Head & Neck (Thyroid, Parathyroid, Parotid) 76536

77073 BREAST77075 Breast Complete (Unilateral) 76641

ABDOMEN 1v 2v 3v 4v+ Breast Limited (Unilateral) 76642Abdomen AP and Add'l Oblique and Cone Views 74019 74021 74021 CHESTAbdomen Complete Acute Abdomen Series 74022 Chest for Pleural Effusion, Fluid and/ or Masses in Chest 76604Abdomen Complete Incl. Decubitus & Erect Views 74019 74021 74021 ABDOMENAbdomen, AP, Single View KUB 74018 Abdomen (Complete) 76700HEAD, NECK & OROFACIAL BONES 1v 2v 3v 4v+ Abdomen (Ltd) 1 Org/Quad; F/U; Inguinal Hern; R/O Hern; 76705Facial Bones 70140 70150 KIDNEY/RENALMandible 70100 70110 Kidney/Renal Complete; Retroperitoneal 76770Mastoids 70120 70130 PELVISNasal Bones 70160 Pelvic Limited (Non OB); Inguinal Hern; R/O Hern; Groin Pain 76857Sinuses/ Paranasal 70210 70220 Pelvic Complete (Non Obstetric) 76856Skull 70250 70260 Transvaginal (Non Obstetric) 76830Neck, Soft Tissue 70360 GENITALIA (MALE)Orbits 70200 Prostate (Non-Transrectal) 76856Temporomandibular Joint, Open/Closed, Bilateral 70330 Scrotum and Contents (Testicles) 76870CHEST 1v 2v 3v 4v+ OBSTERICALChest 71045 71046 71047 71048 OB (1st Trimester <14 Weeks 0 days) 76801Chest, 2 Views w/ Apical Lordotic Procedure 71047 OB (2nd & 3rd Trimester > or = 14 Weeks 0 Days) 76805Chest, 2 Views w/ Oblique Projections 74022 71047 71048 OB Limited (Fetal Heartbeat, Placental & Fetal Position) 76815Chest Special Views 71046 71047 71048 OB Transvaginal 76817Clavicle Complete 73000 OB Follow Up (Re-Evaluate Fetal Size & Organ Sys.) 76816Ribs, Unilateral 71100 71101 SOFT TISSUE Ribs, Bilateral 71110 71111 Exam of Upper & Lower Extremities (Complete) 76881Sternum 71120 71130 Exam of Upper & Lower Extremities (Limited) 76882SPINE 1v 2v 3v 4v+ Axilla 76882Cervical Spine **(6 or more views use CPT 72052) 72040 72050 Chest Wall (Limited) 76604-52Cervical Spine Complete, Incl Oblique; Flex & Ext 72052 Pelvic Wall (Retroperitoneal Region, Penis, Perinum) 76857Lumbosacral, AP & Lateral 72100 72100 72110 Buttock 76857Lumbosacral, Bending Views Only 72120 72120 Groin (Hip Groin Region & Peripheral Nerves) 76882Lumbosacral, Complete Incl. Bending Views 72114 Other Soft Tissue 76999Sacrum & Coccyx 72220 INFANTSSacroiliac Joints 72200 72202 Infant Hips Dynamic (w/ Physician Manipulation) 76885

72081 72082 72082 72083 SPINESpinal Canal & Contents 76800

Spine, Single View, Specify Level (Scoliosis) 72020 VASCULAR ULTRASOUND DUPLEX/DOPPLERThoracic 72070 72072 72074 VENOUS REFLUX EXTREMITYThoracolumbar Junction 72080 Duplex extremity veins - Complete Bilateral 93970SHOULDER, UPPER ARM & ELBOW 1v 2v 3v 4v+ Duplex extremity veins - Limited/ Unilateral 93971Acromioclavicular Joint Bilat w/ or w/o Weights 73050 ARTERIAL EXTREMITYElbow 73070 73080 Duplex Lower Extremities Arteries Complete Bilateral 93925Humerus 73060 Duplex Lower Extremity Arteries Limited/ Unilateral 93926Scapula Complete 73010 Duplex Upper Extremities Arteries Complete Bilateral 93930Shoulder 73020 73030 Duplex Upper Extremity Arteries Limited/ Unilateral 93931FOREARM, HAND & FINGERS 1v 2v 3v 4v+ ABI 93922Fingers 73140 CAROTIDForearm 73090 Duplex Extracranial Arteries Complete Bilateral 93880Hand 73120 73130 AORTAWrist 73100 73110 Abdominal/ Aorta - Screening AAA 76706LOWER LEG, KNEE, ANKLE & FOOT 1v 2v 3v 4v+ KIDNEY/ RENALCalcaneus or Heel 73650 Renal Arterial Complete 93975Foot 73620 73630 DIGITAL MAMMOGRAPHYAnkle 73600 73610 CHESTTibia & Fibula 73590 Screening, Bilateral; All Views (formerly G0202) 77067Toe(s) 73660 Diagnostic, Bilateral; All Views (formerly G0204) 77066Knee 73560 73560 73562 73564 Diagnostic, Unilateral; All Views (formerly G0206) 77065Knee, Both, Standing AP 73565 Spot Compression, Bilateral (formerly G0204) 77066PELVIC REGION, HIP & THIGH 1v 2v 3v 4v+ Spot Compression, Unilateral (formerly G0206) 77065Femur 73551 73552 Implants (formerly G0204) 77066Hip Unilateral, Incl. AP of Pelvis 73501 73502 73502 73503 DEXA (BONE DENSITOMETRY)Hip Bilateral, Incl. AP of Pelvis **(5 v+ use CPT 73521 73522 73522 Dual-Energy X-Ray (DEXA) 77080Pelvis 72170 72170 ECHOCARDIOGRAPHY

Echocardiography; Transthoracic, Complete 93306Rev 01282021 © Copyright | Centrelake 2021

Spine, Scoliosis Study, Incl. Supine & Erect **(6 or more views use CPT 72084)

DIAGNOSTIC RADIOLOGY CPT GUIDE 2021X-RAY

Bone Length Studies (Scanogram/ Orthoroentgenogram)Bone Survey - Skeletal