Mercy Health Plans - RadConsult

RadConsult^©

CT
70450, 70460, 70470	CT Head or Brain
70480, 70481, 70482	CT Orbits, Sella, Posterior-Fossa, IACs
70486, 70487, 70488	CT Maxillofacial (Sinuses)
70490, 70491, 70492	CT Neck
71250, 71260, 71270	CT Chest
72125, 72126, 72127	CT Cervical Spine
72128, 72129, 72130	CT Thoracic Spine
72131, 72132, 72133	CT Lumbar Spine
72192, 72193, 72194	CT Pelvis
73200, 73201, 73202	CT Upper Extremity
73700, 73701, 73702	CT Lower Extremity
74150, 74160, 74170	CT Abdomen
76380	CT Limited Study or Follow-up
CTA
70496	CT Angiography, Head, with contrast material(s), including noncontrast images, if performed, and image postprocessing
70498	CT Angiography, Neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing
71275	CT Angiography, Chest, with contrast material(s), including noncontrast images, if performed, and image postprocessing
72191	CT Angiography, Pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing
73206	CT Angiography, Upper Extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing
73706	CT Angiography, Lower Extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing
74175	CT Angiography, Abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing
75635	CT Angiography, Abdominal Aorta and Bilateral lliofemoral Lower Extremity Runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing
MRA
70544, 70545, 70546	MRA Brain
70547, 70548, 70549	MRA Neck
71555, C8909, C8910, C8911	MRA Chest
72159	MRA Spinal Canal and Contents
72198, C8918, C8919, C8920	MRA Pelvis
73255	MRA Upper Extremity
73725, C8912, C8913, C8914	MRA Lower Extremity
74185, C8900, C8901, C8902	MRA Abdomen
MRI
70336	MRI TMJs - Temporomandibular joint(s)
70540, 70542, 70543	MRI Orbits, Face, Neck
70551, 70552, 70553	MRI Brain (including brain stem)
71550, 71551, 71552	MRI Chest
72141, 7214272156	MRI Cervical Spine
72146, 72147, 72157	MRI Thoracic Spine
72148, 72149, 72158	MRI Lumbar Spine
72195, 72196, 72197	MRI Pelvis
73218, 73219, 73220	MRI Upper Extremity Other than Joint
73221, 73222, 73223	MRI Upper Extremity, Joint (Shoulder, Elbow, Wrist)
73718, 73719, 73720	MRI Lower Extremity Other than Joint
73721, 73722, 73723	MRI Lower Extremity, Joint (Knee, Hip, Joint, Ankle)
74181, 74182, 74183	MRI Abdomen
75557	MRI Cardiac for Morphology and Function without contrast
75558	MRI Cardiac for Morphology and Function without contrast; with flow/velocity quantification
75559	MRI Cardiac for Morphology and Function without contrast; with stress imaging
75560	MRI Cardiac for Morphology and Function without contrast; with flow/velocity quantification and stress
75561	MRI Cardiac for Morphology and Function w/o contrast material(s), followed by contrast material(s) and further sequences
75562	MRI Cardiac for Morphology and Function w/o contrast material(s), followed by contrast material(s) and further sequences; with flow/velocity quantification
75563	MRI Cardiac for Morphology and Function w/o contrast material(s), followed by contrast material(s) and further sequences; with stress imaging
75564	MRI Cardiac for Morphology and Function w/o contrast material(s), followed by contrast material(s) and further sequences; with flow/velocity quantification and stress
77058	MRI Breast - Unilateral without and/or with contrast
77059	MRI Breast - Bilateral without and/or with contrast
77084	MRI - Bone Marrow Blood Supply
Nuclear Cardiac
78460, 78461	Cardiac Nuclear Stress Tests
78464, 78465	Cardiac Nuclear Stress Tests SPECT
78466	Myocardial Imaging, infarct avid, planar; qualitative or quantitative
78468	Myocardial Imaging with ejection fraction, first pass technique
78469	Myocardial Imaging, tomographic SPECT with or without quantification
78472	Cardiac Blood Pool Imaging, gated equilibrium; planar, single study Rest or Sress, wall motion study + ejection fraction, w/ or w/o quantitative processing
78473	Cardiac Blood Pooling Imaging, multiple studies, wall motion study plus ejection fraction, at rest or stress, w/ or w/o additional quantification
78478	Myocardial Perfusion Study with wall motion, qualitative or quantitative study
78480	Myocardial Perfusion Study with ejection fraction
78481	Cardiac Blood Pool Imaging, planar, first pass technique, single study, rest or stress, wall motion study + ejection fraction, w/ or w/o quantification
78483	Cardiac Blood Pool Imaging, multiple studies, rest and stress, wall motion study + ejection fraction, w/ or w/o quantification
78484	Cardiac Blood Pool Imaging, gated equilibrium, SPECT; planar, single study rest or stress, wall motion study + ejection fraction, w/ or w/o quantitative processing
78496	Cardiac Blood Pool Imaging, gated equilibrium; single study at rest w/ rt. ventricular ejection fraction by first pass technique
PET
78459	PET Myocardial Imaging, Metabolic Evaluation
78491	PET Myocardial Imaging, Perfusion at Rest or Stress
78492	PET Myocardial Imaging, Perfusion at Rest or Stress, Multiple Studies
78608	PET Brain, Metabolic Evaluation
78609	PET Brain, Perfusion Evaluation
78811	PET; limited area (eg, chest, head/neck)
78812	PET; skull base to mid-thigh
78813	PET; whole body
78814	PET with concurrent CT for attentuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)
78815	PET with concurrent CT for attentuation correction and anatomical localization imaging; skull base to mid-thigh
78816	PET with concurrent CT for attentuation correction and anatomical localization imaging; whole body
G0219	PET Imaging whole body for Melanoma for Noncovered Indications
G0235	PET Imaging, any site, not otherwise specified
G0252	PET imaging, Breast Cancer Imaging, Diagnosis and/or Surgical Planning
G0330	PET initial diagnosis cervical
G0331	PET restaging ovarian
Category III
0067T	Computed tomographic (CT) colonography (ie, virtual colonoscopy); diagnostic
0144T	CT, heart, without contrast material, including image post processing and quantitative evaluation of coronary calcium
0145T	CT, heart, with contrast material(s), including noncontrast images, if performed, cardiac gating and 3D image postprocessing; cardiac structure and morphology
0146T	CT, heart, with contrast material(s), including noncontrast images, if performed, cardiac gating and 3D image postprocessing; CT angiography of coronary arteries (including native and anomalous coronary arteries, coronary bypass grafts), w/o quantitative eval of coronary calcium
0147T	CT, heart, with contrast material(s), including noncontrast images, if performed, cardiac gating and 3D image postprocessing; CT angiography of coronary arteries (including native and anomalous coronary arteries, coronary bypass grafts), with quantitative eval of coronary calcium
0148T	CT, heart, with contrast material(s), including noncontrast images, if performed, cardiac gating and 3D image postprocessing; cardiac structure and morphology and CT angiography of coronary arteries (including native and anomalous coronary arteries, coronary bypass grafts), w/o quantitative eval of coronary calcium
0149T	CT, heart, with contrast material(s), including noncontrast images, if performed, cardiac gating and 3D image postprocessing; cardiac structure and morphology and CT angiography of coronary arteries (including native and anomalous coronary arteries, coronary bypass grafts), with quantitative eval of coronary calcium
0150T	CT, heart, with contrast material(s), including noncontrast images, if performed, cardiac gating and 3D image postprocessing; cardiac structure and morphology in congenital heart disease
0151T	CT, heart with contrast material(s), including noncontrast images, if performed, cardiac gating and 3D image postprocessing, function eval (left and right ventricular function, ejection fraction and segmental wall motion)

CPT