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Annual breast MRI inaddition to screeningmammograms( 3D Tomosynthesis) Screeningmammographyshould start 10years before theage of a breastcancer diagnosis ina 1st degree relative(though not beforeage 25)SPECIAL CIRCUMSTANCESOrder diagnosticmammogram( 3D Tomosynthesis)w/ultrasound, ifclinically indicated 3 years lumpectomy Suspected leakage implant Skin thickening or retraction Six month follow-upWHAT IS THE ARIZONA DENSE BREAST LAW?The law requires that a health care institution or facility that categorizes a patient ashaving heterogeneously dense or extremely dense breasts based on breast imagereporting and the data system (BIRADS) established by the American College ofRadiology, must include the following in the summary of the mammography reportsent to the patient:www.radltd.comHIGH RISK PATIENTHigh risk patients including those who: Have a known BRCA1 or BRCA2 gene mutation Have a first-degree relative (parent, brother, sister, or child)with a BRCA1 or BRCA2 gene mutation, and have not hadgenetic testing themselves Have a lifetime risk of breast cancer of 20% to 25% or greater.The Tyrer-Cuzick breast cancer risk assessment model isperformed on all our screening patients Had radiation therapy to the chest when they were betweenthe ages of 10 and 30 years Have Li-Fraumeni syndrome, Cowden syndrome, or BannayanRiley-Ruvalcaba syndrome, or have one of these syndromes infirst-degree relativesBREAST IMAGINGMAMMOGRAPHY ORDERINGDECISION TREEYour mammogram indicates that you have dense breast tissue. Dense breast tissueis common and is found in fifty percent of women. However, dense breast tissue canmake it more difficult to detect cancers in the breast by mammography and may also beassociated with an increased risk of breast cancer. This information is being provided toraise your awareness and to encourage you to discuss with your health care providersyour dense breast tissue and other breast cancer risk factors. Together, you and yourphysician can decide if additional screening options are right for you. A report of yourresults was sent to your physician.This law went into effect October 1, 2014.To schedule an appointment, call (520) 733-7226 or fax (520) 290-8377.10

BREAST IMAGINGBREAST IMAGING: Screening andDiagnostic MammographyThis is for reference only. This does not imply protocol standardsfor all radiology facilities. Information is subject to change.PATIENT SYMPTOMS &CODESPARAMETERSSUGGESTEDTEXTFOR ORDER Asymptomatic AnnualScreening (G0202) CAD for Screening (77052) Screening Breast 3DTomosynthesis (77063) Annual after age 40(12 months and1 day since lastscreening exam) ScreeningMammogram ScreeningMammogram(specify baseline orannual exam) Implants(G0202) CAD for Screening(77052) Annual after age 40(12 months and1 day since lastscreening exam) ScreeningMammogram ScreeningMammogram(specify patient hasimplants and is NOTsymptomatic butneeds extra time forexam) MastectomyAnnual Screening (G020252) CAD for Screening (77052) Annual Screening of Screeninguntreated breast (12 Mammogrammonths and 1 daysince last exam) Unilateral ScreeningMammogram History of Breast Cancer(G0204 / Bilateral)(G0206 / Unilateral) CAD for Diagnostic (77051) Unilateral Breast 3DTomosynthesis (77061) Bilateral Breast 3DTomosynthesis (77062) Lumpectomy 6 months postsurgery Annual 3 years DiagnosticMammogram DiagnosticMammogram:Personal Historyof Breast Cancer—Lumpectomy Clinical Findings—Symptoms(G0204 / Bilateral)(G0206 / Unilateral) CAD (77051) Mass DiagnosticMammogram DiagnosticMammogram: WithUltrasound (identifyarea of mass) Pain—Localized DiagnosticMammogram DiagnosticMammogram:Pain (identifyarea of pain)With Ultrasound(localized pain) DiagnosticUltrasound Diagnostic BreastUltrasound WithMammogram (ifneeded) Under 30 Years of Age— Mass Discharge—Order UltrasoundLocalized pain(76641 / Unilateral, Complete)(76642 / Unilateral, Limited)11ORDER /PERFORM3D mammography may be ordered as an adjunct to screening ordiagnostic mammography, if the patient has dense breasts or it isappropriateotherorreasons.To scheduledeemedan appointment,call (520)for733-7226fax (520) 290-8377.

This is for reference only. This does not imply protocol standardsfor all radiology facilities. Information is subject to change.PATIENT SYMPTOMSPARAMETERS Recommendation Short Term Follow-UpExamof Previous Exam Recommendation of(3-6 months)Additional Imaging(Callback or Recall Exam) Post Biopsy Exam(1-11 monthsafter previousmammogram) Mammography Indeterminate Lesion DiagnosticMammogram DiagnosticMammogram MammogramAdditionalExam Ultrasound Ultrasound Unilateral Reproducible Single DuctDischarge (patientmust be able toexpress dischargeat time ofductogram) DiagnosticMammogramFirst Found onUltrasound UltrasoundVisualizing SolidLesion Left / RightDuctogram UltrasoundGuided CoreBiopsySUGGESTEDTEXTFOR ORDER DiagnosticMammogram:Short-TermFollow-Up DiagnosticMammogram:Post Biopsy Radiology Ltd. willcontact the patientto schedule thisexam. A reportwith the finalrecommendationwill be sent to thereferring provider. Ultrasound (asspecified in callback indicated onmammographyreport) DiagnosticMammogram:Discharge(identify breastand describedischarge) Ductogram forNipple Discharge Left / RightIndeterminateLesion / MassTo schedule an appointment, call (520) 733-7226 or fax (520) 290-8377.www.radltd.com Nipple DischargeORDER /PERFORMBREAST IMAGINGBREAST IMAGING: Additional Imagingand Procedures12

BREAST IMAGINGBREAST IMAGING: Breast MRIThis is for reference only. This does not imply protocol standardsfor all radiology facilities. Information is subject to change.PATIENT SYMPTOMS Cystic Mass / LesionFound on Previous BreastUltrasound High Risk Patient Pre-Operative Staging Silicone Implants andPalpable Lump, Pain orAbnormal MammogramPARAMETERSSUGGESTEDTEXTFOR ORDER Previous Left / Right Left / Right CysticUltrasound ReportCysticAspirationIndicating Need for AspirationAspiration See high risk Bilateral Breast Bilateral Breast MRIpatient parameters MRIon page 10 Recent Diagnosis Bilateral Breast Bilateral Breast MRIof Breast CancerMRI (and(and Chest MRI, ifChest MRI, ifnecessary)necessary) Suspected Silicone Bilateral Breast Bilateral Breast MRIImplant LeakMRI“Implant Protocol” Further Evaluationof IndeterminateClinical or ImagingResults (“radiologistrecommendation”) Follow-Up for Follow-Up forChemotherapy Treatment Neo-AdjuvantChemotherapy Indeterminate Clinical orImaging ResultsORDER /PERFORM Bilateral Breast Bilateral Breast MRIMRI Bilateral Breast Bilateral Breast MRIMRIRadiology Ltd. provides a Patient Education Specialistfor Women’s Imaging, who will be solely dedicatedto support you and your patients.The Patient Education Specialist brings a wealth of knowledge toboth patients and the referring physician community.If you have questions and would like to speak with ourPatient Education Specialist, she can be reached at (520) 901-6668.13To schedule an appointment, call (520) 733-7226 or fax (520) 290-8377.

PET/CTPET / CT: GeneralThis is for reference only. This does not imply protocol standardsfor all radiology facilities. Information is subject to change.BODY PARTREQUESTED TEXTCODE Skull Base toMid-Thigh Whole Body PET / CT Skull Base to Mid-Thigh (all other diagnoses) Brain PET / CT Brain78608 Myocardium PET / CT Myocardium(Cannot be done if patient is diabetic)7845978815 PET / CT Whole Body (Diagnosis: Melanoma, Myeloma, 78816Sarcoma, & Merkel Cell Carcinoma, CutaneousLymphoma)This is for reference only. This does not imply protocol standardsfor all radiology facilities. Information is subject to change.BODY PART Breast Lung Prostate ThyroidREQUESTED TEXTCODE PET / CT Bone Scan With Sodium Fluoride78816(This is covered only if the patient is entered into theNational Pet Registry and is only open to Medicare eligiblepatients. )www.radltd.comPET / CT: Bone ScanOur PET services are centrally located at ourCamp Lowell site. To schedule a PET exam,please call (520) 545-1906, opt. 3.To schedule an appointment, call (520) 733-7226 or fax (520) 290-8377.14

ULTRASOUNDULTRASOUND: GeneralThis is for reference only. This does not imply protocol standardsfor all radiology facilities. Information is subject to change.BODY PART Abdomen Pelvic Area(Non-OB) Aorta(Seen toIliacs)15REASON FOR EXAM Abdominal Pain Above Umbilicus Abnormal LFT’s Cirrhosis Hepatitis C Hepatomegaly Polycystic Disease Splenomegaly Endometriosis Fibroids / Enlarged Uterus Inguinal Hernia IUD Menstrual Disorders Ovarian Cysts PCOS Pelvic Pain Below—Umbilicus (relatingspecifically to uterus or ovaries;ultrasound is not the exam of choicefor intestinal disorders) AAA Abd Bruit / Pulsatile Mass Aortic Dissection AAA Screening for Medicare–Must be referred from InitialPreventative Physical Exam (IPPE)–Patient must have at least one of thefollowing risks: Family Hx of AAA 65-75 year old male who hassmoked “at least 100 cigarettes” Additional risk factors includecoronary heart disease, hypertension, cerebrovascular diseasePROCEDURECODE AbdominalUltrasound76700 Pelvic Ultrasound76856TransAbdominal76830TransVaginal Abdominal AortaUltrasound76775 Abdominal AortaUltrasound–MedicarescreeningG0389To schedule an appointment, call (520) 733-7226 or fax (520) 290-8377.

This is for reference only. This does not imply protocol standardsfor all radiology facilities. Information is subject to change.BODY PARTREASON FOR EXAMPROCEDURECODE Flank / Back Pain Hematuria Incomplete Bladder Emptying Neurogenic Bladder Polycystic Kidneys Renal Cyst / Mass Renal Disease (CKD) UTI Renal Ultrasound76770 Bladder Bladder Mass / Stone Check Post Void Residual Hematuria BladderUltrasound76857 Thyroid orSoft TissueNeck Enlarged Lymph Node Enlarged Thyroid / Fullness Goiter Hypo- / Hyper-Thyroid Nodules Palpable Mass on Neck Thyroiditis ThyroidUltrasound76536 Testicles Epididymitis Hydrocele Orchalgia Pain / Swelling Torsion Varicocele TesticularUltrasound76870www.radltd.com KidneysULTRASOUNDULTRASOUND: GeneralLocally owned and operated, Radiology Ltd. offersseven imaging centers to patients across southern Arizona.To schedule an appointment, call (520) 733-7226 or fax (520) 290-8377.16

ULTRASOUNDULTRASOUND: VascularThis is for reference only. This does not imply protocol standardsfor all radiology facilities. Information is subject to change.BODY PARTREASON FOR EXAM Amaurosis Fugax Arterial Vascular Disease Ataxia HTN Hyperlipidemia Stenosis Stroke TIA DVT Venous Redness Upper Refluxand Lower Upper and LowerExtremityExtremity Swelling / Pain Valvular Incompetency Abdominal Portal HTN Portal Venous Thrombosis Liver Transplant TIPS Renal Artery Abd Bruit Renal Artery Stenosis Uncontrolled HTN CarotidPROCEDURECODE Carotid Duplex /Doppler93880 Venous Duplex /Doppler93971 Unilat AbdominalDuplex / Doppler93975 Renal ArteryDuplex / Doppler93975Dup Scan Complete(Abdominal, Pelvic,Scrotal contents and/orretroperitoneal organs)93970 Bilat93976Duplex Scan LimitedRadiology Ltd. –the best care,the best technology,and the best expertise,right in your own backyard.17To schedule an appointment, call (520) 733-7226 or fax (520) 290-8377.

This is for reference only. This does not imply protocol standardsfor all radiology facilities. Information is subject to change.BODY PARTREASON FOR EXAMPROCEDURECODE Lymphadenopathy Palpable Abnormality Soft Tissue Ultrasound Neck 76536/ Head Hands /Wrists Foreign Body Ganglion Cyst Pain / Swelling Palpable Abnormality Radial / Ulnar Nerve Rheumatoid Arthritis / Arthritis Foreign Body Ganglion Cyst Morton’s Neuroma Pain Palpable Abnormality Plantar Fasciitis Plantar Plate Tear Achilles Tendon Ganglion Cysts Foreign Body Pain / Swelling Palpable Abnormality Tendonitis (Anterior Tibialis,Posterior Tibialis, Peroneals) Baker’s Cyst Pain / Swelling Palpable Abnormality Patellar Tendon Quadriceps Tendon Biceps Rupture Bursitis Pain / Swelling Palpable Abnormality Ulnar Nerve Inguinal Hernia Lymphadenopathy Palpable Abnormality Palpable Abnormality on theBack or Torso Soft Tissue Hands / WristsUltrasound76881 Soft Tissue Foot Ultrasound76881 Soft Tissue AnkleUltrasound76881 Foot Ankle Knee Elbow Groin Unlistedwww.radltd.com Neck / HeadULTRASOUNDULTRASOUND: MSK/Extremity Soft Tissue Knee Ultrasound 76881 Soft Tissue ElbowUltrasound76881 Soft Tissue Groin Ultrasound 76881 Chest Wall Upper Back Lower Back766047660476705To schedule an appointment, call (520) 733-7226 or fax (520) 290-8377.18

CT / CTACPT CODES for CT SCANSThis is for reference only. This does not imply protocol standards for all radiologyfacilities. Information is subject to change.ORBIT / FACE70480 - W/O CONTRAST70481 - W/ CONTRAST70482 - W/O & W/ CONTRASTBRAIN70450 - W/O CONTRAST70460 - W/ CONTRAST70470 - W/O & W/CONTRASTMAXILLOFACIAL70486 - W/O CONTRAST70487 - W/ CONTRAST70488 - W/O & W/ CONTRASTCERVICAL SPINE72125 - W/O CONTRAST72126 - W/ CONTRAST72127 - W/O & W/ CONTRASTSOFT TISSUE NECK70491 - W/ CONTRASTCHEST71250 - W/O CONTRAST71260 - W/ CONTRAST71270 - W/O & W/ CONTRASTUPPER EXTREMITY73200 - W/O CONTRAST73201 - W/ CONTRAST73202 - W/O & W/ CONTRASTLOWER EXTREMITY73700 - W/O CONTRAST73701 - W/ CONTRAST73702 - W/O & W/ CONTRASTTHORACIC SPINE72128 - W/O CONTRAST72129 - W/ CONTRAST72130 - W/O & W/ CONTRASTABDOMEN PELVISCOMBINATION74176 - W/O CONTRAST74177 - W/ CONTRAST74178 - W/O & W/ CONTRASTLUMBAR SPINE72131 - W/O CONTRAST72132 - W/ CONTRAST72133 - W/O & W/ CONTRAST19To schedule an appointment, call (520) 733-7226 or fax (520) 290-8377.

CT / CTACT / CTA: GeneralThis is for reference only. This does not imply protocol standardsfor all radiology facilities. Information is subject to change.BODY PARTREASON FOR EXAM Lung Nodules (1st exam) Chest71270 Abnormal Chest X-ray COPD Cough Esophageal CA Hemoptysis Lung CA Lymphoma Mass Pneumonia Shortness of Breath Tracheal Stenosis Asbestosis Bronchiectasis Fibrosis Interstitial Lung Disease Pleural Plaques Sarcoidosis Pulmonary Embolism Shortness of Breath Vascular Evaluation Aortic Dissection Thoracic Aortic Aneurysm CT Chest With Contrast71260 CT Chest Without Contrast,High-Resolution71250 CTA Chest71275 CTAChest &Abdomen CTA Chest and Abdomen7127574175 Neck Cancer Workups Dysphagia Infection Infection of Parotid Gland Infection of SubmandibularGland Lymphadenopathy Mass Parotid Mass Parotid Stone Submandibular Stone CT Neck With Contrast7049171250To schedule an appointment, call (520) 733-7226 or fax (520) 290-8377.www.radltd.com CTA Chest(PE Study)CODE CT Chest Without and WithContrast CT Chest Without Contrast Lung Nodules (follow-up) Chest,HighResolutionPROCEDURE20

CT / CTACT / CTA: GeneralThis is for reference only. This does not imply protocol standardsfor all radiology facilities. Information is subject to change.BODY PARTREASON FOR EXAMCODE Pelvis(SoftTissue) Cancer Staging Cysts Hernia Infection Mass Pain CT Pelvis With Contrast72193 Pelvis(Bone) Fracture, Non-Arthritis Union CT Pelvis Without Contrast72192 Bone Infection Cancer / Mass / Mets / Tumor CT Pelvis With Contrast72193 Abdomen /Pelvis Stone (Stone protocol) CT Abdomen and PelvisWithout Contrast (Stoneprotocol)Area of Concern:74176 Abdominal Pain Abscess Hernia (ie, ventral, umbilical,inguinal) Mass Adrenal Liver21PROCEDURE Any Cancer Staging Appendicitis Crohns / Ulcerative Colitis Diarrhea Diverticulitis IBD Adrenal Mass Hepatoma, Hepatitis, Cirrhosis Liver Hemangioma(MR preferred)Above Iliac Crest (hip bone) CT Abdomen With Contrast74160Below Iliac Crest (hip bone) CT Pelvis With Contrast72193Location unknown or bothareas apply74177 CT Abdomen and Pelvis WithContrast CT Abdomen and Pelvis With 74177Contrast CT Abdomen With andWithout Contrast CT Abdomen With andWithout Contrast (Liverprotocol)To schedule an appointment, call (520) 733-7226 or fax (520) 290-8377.7417074170

CT / CTACT / CTA: GeneralThis is for reference only. This does not imply protocol standardsfor all radiology facilities. Information is subject to change.BODY PART PancreasREASON FOR EXAM Pancreatic Mass Pancreatitis PseudocystPROCEDURECODE CT Abdomen Without andWith Contrast (Pancreaticprotocol 1st time) CT Abdomen With Contrast74170 CT Abdomen Withoutand With Contrast (Kidneyprotocol) CT IVP or CT Urogram7417074160 Kidney Any Renal Pathology CTUrogram /CT IVP Transitional Cell Carcinoma ofKidney and/or Bladder Hematuria Claudication CTA Abdomen and Run Off Peripheral Artery Disease (PAD)74178 Mesenteric Ischemia Renal Artery Stenosis CTA Abdomen74175 AAA Crossing Vessels Stent Obstruction / Leak /Malfunction C

PET / CT Tel: (520) 545-1906, opt. 3 Fax: (520) 545-1898 IMPORTANT CONTACT INFORMATION 2. 3 Digital X-rays are done on a walk-in basis. REFERENCE CONTENTS . DEXA Body Composition Study DEXA 76499 Radiology Ltd. is committed to the health of southern Arizona by providing the m