Transcription
COMPUTED TOMOGRAPHY (CT) SCANSExam Reference / Protocol GuidelinesAdRad.comFor additional information on CT and other radiologic exams,please consult the American College of Radiology’sACR Appropriateness Criteria document found at www.ACR.org.203.337.XRAY (9729)AREA OF INTERESTHEAD 2016 Advanced Radiology ConsultantsBODY PART REASON FOREXAMEXAMORALIVPROCEDURESCONTRAST CONTRAST TO PRE-CERTCODESBleed, trauma, headachesNONOCT Brain without70450Mass, tumor, infection,melanoma, HIV,meningioma,mets stagingNOYESCT Brain withand without70470CTA HEADAneurysmNOYESCTA Head70496CTA NECKCarotid OcclusionNOYESCTA Neck70498ORBITSTrauma, fracture,foreign bodyNONOCT Orbits without70480Mass, abcess, pain, swelling,Graves disease, cellulitisNOYESCT Orbits with70481SINUSSinusitus, mass, pain,polyps, deviated septum,congestion, foreign bodyNONOCT Sinus without70486FACETrauma, fractureNONOCT Maxillofacial70486TEMPORALBONESCholestatoma, tinnitis,congenital hearing lossNONOCT Temporal Boneswithout70480SOFT TISSUENECKPalpable neck mass,stone, neoplasmNOYESCT Neck with andwithout70492Lymphoma,lymphadenopathyNOYESCT Neck with andwithout70492Parotid swelling,vocal chord paralysisNONOCT Neck without70490BRAIN
COMPUTED TOMOGRAPHY (CT) SCANSExam Reference / Protocol GuidelinesAdRad.comFor additional information on CT and other radiologic exams,please consult the American College of Radiology’sACR Appropriateness Criteria document found at www.ACR.org.203.337.XRAY (9729)AREA OF INTERESTABDOMENBODY PART REASON FOREXAMEXAMABDOMEN:from lung baseto illiac crestPELVIS:from iliaccrest to pubisPainLIVER 2016 Advanced Radiology ConsultantsYESIVPROCEDURES CODESCONTRAST TO PRE-CERTNOCT Abdomen74176Pelvis withoutPain, fracture, arthritis,mets, bone lesionSoft tissue mass, tumor,abcess, infection,cellulitisABDOMENMass, hernia,AND PELVISdiverticulitis,GENERAL:appendicitis, restagingfrom lung base CA, nausea, vomitingto ��s disease,small bowelobstructionIncrease LFTs,RUQ pain, jaundice,liver cancer,cirrhosis, hepatoma,hemangioma, hepatitisCT PelviswithoutCT Pelvis with72192YESCT Pelvis withand without74178YES35 years of ageor older:CT Abdomen withand withoutPelvis with35 years of ageor younger:CT Abdomen andPelvis with only74178CT Abdomen withand without74178NONOYESYESYESYESArrive 1 hour prior to appt.time, patient must drinkoral contrast in the officeYESYESCT Pelvis with7219374176
COMPUTED TOMOGRAPHY (CT) SCANSExam Reference / Protocol GuidelinesAdRad.comFor additional information on CT and other radiologic exams,please consult the American College of Radiology’sACR Appropriateness Criteria document found at www.ACR.org.203.337.XRAY (9729)AREA OF INTERESTRENALBODY PARTEXAMREASON FOREXAMRENALRenal stoneNONOCT Abdomen withoutPelvis without74176MassNOYESCT Abdomen with andwithoutCT Pelvis with74178HematuriaNOYESCT Abdomen with andwithoutCT Pelvis with ST CONTRAST TO PRE-CERTWITH 3D 2016 Advanced Radiology ConsultantsCODES76377CTA ABDOMENAAA, renal artery stenosis,dissection, hypertensionNOYESCTA Abdomen74175CTA ABDOMENAND PELVISAAA, renal artery stenosis,dissection, hypertensionNOYESCTA Abdomen and Pelvis74174CTA RUNOFF(PAD) Peripheral ArteryDiseaseNOYESCTA Abdomen AortaRunoff75635CHESTNodule, opacities seenNONOCT Chest without71250Hilar adenopathy,lung cancerNOYESCT Chest with71260CTA CHESTPulmonary embolismAneurysmNOYESCTA Chest71275HIGHRESOLUTIONInterstitial lung diseaseNONOCT Chest high resolutionwithout70490
COMPUTED TOMOGRAPHY (CT) SCANSExam Reference / Protocol GuidelinesAdRad.comFor additional information on CT and other radiologic exams,please consult the American College of Radiology’sACR Appropriateness Criteria document found at www.ACR.org.203.337.XRAY (9729)AREA OF INTERESTEXTREMITIESBODY PARTEXAMREASON FOREXAMUPPEREXTREMITIES:Pain, arthritis, fracture,fusion, malunionNONOCT Upper Extremitywithout contrast73200Infection, tumor, mass,cancer, mets (MRI ismore sensitive)NOYESCT Upper Extremity withcontrast73201Pain, arthritis, fracture,fusion, malunionNONOCT Lower Extremitywithout contrast73700Infection, tumor, mass,cancer, mets (MRI ismore sensitive)NOYESCT Lower Extremity withcontrast73701Immediate Post-opNOYESCT Cervical Spine with72126Neck pain, fracture,eval hardwareNONOCT Cervical Spinewithout72125Immediate Post-opNOYESCT Thoracic Spine with72129Pain, fracture,eval hardwareNONOCT Thoracic Spinewithout72128Immediate Post-opNOYESCT Lumbar Spine with72132Pain, fracture,eval hardwareNONOCT Lumbar Spinewithout72131hand, wrist, elbow,forearm, humerus,shoulderLOWEREXTREMITIES:foot, ankle, knee, hip,tibia, fibula, femurCERVICALSPINETHORACIC SPINELUMBARSPINE 2016 Advanced Radiology ConsultantsORALIVPROCEDURESCONTRAST CONTRAST TO PRE-CERTCODES
COMPUTED TOMOGRAPHY (CT) SCANSExam Reference / Protocol GuidelinesAdRad.com203.337.XRAY (9729)For additional information on CT and other radiologic exams,please consult the American College of Radiology’sACR Appropriateness Criteria document found at www.ACR.org.Reducing the Risk of Contrast Induced NephrotoxicitySome patients receiving intravenous contrast require bloodwork prior to contrast injectionTHE FOLLOWING PATIENTS SHOULD HAVE A RECENT EGFR (Estimated Glomular Filtration Rate): Age 70 or older History of renal disease - (*note - kidney stones/renal cysts do not require eGFR)- Dialysis- Kidney surgery- Kidney transplant- Kidney cancer- Single kidney History of hypertension requiring medical therapy (patients on high blood pressure medication) History of diabetes mellitus (including patients on metformin)ACCEPTABLE BLOOD WORK GUIDELINES: eGFR should be within 90 days of imaging eGFR should be within 30 days if the patient had a recent hospitalizationDOSING GUIDELINES: eGFR 45 - Technologists can proceed with the contrast injection eGFR is between 30-44 - Radiologist approval is needed prior to injection. Clinical judgement required andoral and/or IV hydration should be considered if patient can tolerate it. eGFR 30 - Radiologist should speak with the ordering clinician for clearance before proceeding with contrast injectionor if alternative tests may be useful for diagnosisDIALYSIS GUIDELINES:Defer to Nephrologist for course of treatment 2016 Advanced Radiology Consultants
CT Abdomen and Pelvis with only 74176 LIVER Increase LFTs, RUQ pain, jaundice, liver cancer, cirrhosis, hepatoma, hemangioma, hepatitis YES YES CT Abdomen with and without CT Pelvis with 74178 AREA OF INTEREST ABDOMEN 2016 Advanced Radiology Consultants AdRad.com 203.337.XRAY (9729) COMPUT
